Provider Demographics
NPI:1710594718
Name:CLUTCH COUNSELING
Entity Type:Organization
Organization Name:CLUTCH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:COSALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-924-1855
Mailing Address - Street 1:2001 E SPRING CREEK PKWY APT 9101
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-3240
Mailing Address - Country:US
Mailing Address - Phone:214-924-1855
Mailing Address - Fax:
Practice Address - Street 1:2001 E SPRING CREEK PKWY APT 9101
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-3240
Practice Address - Country:US
Practice Address - Phone:214-924-1855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty