Provider Demographics
NPI:1497843023
Name:CLEMENT, JAMES ARTHUR (EDS,LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:CLEMENT
Suffix:
Gender:M
Credentials:EDS,LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2168 W MORGAN HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-8784
Mailing Address - Country:US
Mailing Address - Phone:417-388-0199
Mailing Address - Fax:
Practice Address - Street 1:1505 E 20TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-0928
Practice Address - Country:US
Practice Address - Phone:417-627-9601
Practice Address - Fax:417-627-9032
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004020196101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO497412908Medicaid