Provider Demographics
NPI:1427383181
Name:CLAMPITT, RICHARD
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:CLAMPITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:CLAMPITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC,
Mailing Address - Street 1:601 BUNKER HILL ST.
Mailing Address - Street 2:STE E
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654
Mailing Address - Country:US
Mailing Address - Phone:907-376-0776
Mailing Address - Fax:
Practice Address - Street 1:601 N BUNKER HILL ST
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6790
Practice Address - Country:US
Practice Address - Phone:907-376-0776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional