Provider Demographics
NPI:1447599469
Name:CLAYTON, KATHRYN (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 EAGLEBROOKE CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7549
Mailing Address - Country:US
Mailing Address - Phone:314-712-9218
Mailing Address - Fax:
Practice Address - Street 1:232 VANCE RD.
Practice Address - Street 2:STE. 207
Practice Address - City:VALLEY PARK
Practice Address - State:MO
Practice Address - Zip Code:63088-1575
Practice Address - Country:US
Practice Address - Phone:314-712-9218
Practice Address - Fax:636-517-1074
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005009304101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional