Provider Demographics
NPI:1225925530
Name:KIDD, CLAYTON CHRISTOPHER (LSW)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:CHRISTOPHER
Last Name:KIDD
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 E CLARENDON AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4902
Mailing Address - Country:US
Mailing Address - Phone:832-725-5828
Mailing Address - Fax:
Practice Address - Street 1:658 E CLARENDON AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4902
Practice Address - Country:US
Practice Address - Phone:832-725-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150015580104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker