Provider Demographics
NPI:1275861262
Name:CLAY, LOLA M (LPC, BCPC)
Entity Type:Individual
Prefix:
First Name:LOLA
Middle Name:M
Last Name:CLAY
Suffix:
Gender:F
Credentials:LPC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 HIGHWAY 6
Mailing Address - Street 2:SUITE 230 #189
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4876
Mailing Address - Country:US
Mailing Address - Phone:713-459-8505
Mailing Address - Fax:713-400-3549
Practice Address - Street 1:9119 HIGHWAY 6
Practice Address - Street 2:SUITE 230 #189
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4876
Practice Address - Country:US
Practice Address - Phone:713-459-8505
Practice Address - Fax:713-400-3549
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63309101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor