Provider Demographics
NPI:1417720467
Name:CLAYTON & CLAYTON COUNSELING, PLLC
Entity Type:Organization
Organization Name:CLAYTON & CLAYTON COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-708-7411
Mailing Address - Street 1:5062 ROCKROSE CT STE 78
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-7797
Mailing Address - Country:US
Mailing Address - Phone:815-708-7411
Mailing Address - Fax:
Practice Address - Street 1:8038 MACINTOSH LN
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5336
Practice Address - Country:US
Practice Address - Phone:815-708-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty