Provider Demographics
NPI:1417237157
Name:CLAYTON, ROLLIN KENNETH JR (MSW LSW)
Entity Type:Individual
Prefix:MR
First Name:ROLLIN
Middle Name:KENNETH
Last Name:CLAYTON
Suffix:JR
Gender:M
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1293 COPLEY RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-2766
Mailing Address - Country:US
Mailing Address - Phone:330-374-1199
Mailing Address - Fax:330-374-0151
Practice Address - Street 1:1293 COPLEY RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2766
Practice Address - Country:US
Practice Address - Phone:330-374-1199
Practice Address - Fax:330-374-0591
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS276271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical