Provider Demographics
NPI:1427003771
Name:CLAY, MICHAEL DAVID (MA, D MIN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:CLAY
Suffix:
Gender:M
Credentials:MA, D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 5TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2238
Mailing Address - Country:US
Mailing Address - Phone:304-523-9673
Mailing Address - Fax:304-523-9674
Practice Address - Street 1:1005 5TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2238
Practice Address - Country:US
Practice Address - Phone:304-523-9673
Practice Address - Fax:304-523-9674
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV240101Y00000X, 101YA0400X, 101YM0800X, 101YP1600X, 101YP2500X
OHE.1901384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral