Provider Demographics
NPI:1376688960
Name:CLAY COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:CLAY COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANICAL ADVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-587-2972
Mailing Address - Street 1:242 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:WV
Mailing Address - Zip Code:25043-0120
Mailing Address - Country:US
Mailing Address - Phone:304-587-2713
Mailing Address - Fax:304-587-4181
Practice Address - Street 1:242 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:WV
Practice Address - Zip Code:25043-0120
Practice Address - Country:US
Practice Address - Phone:304-587-2713
Practice Address - Fax:304-587-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001020Medicare ID - Type Unspecified