Provider Demographics
NPI:1619572369
Name:CLAYTON, THOMAS PRESTON BRINN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:THOMAS PRESTON
Middle Name:BRINN
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 CHUB LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27574-4871
Mailing Address - Country:US
Mailing Address - Phone:336-504-2449
Mailing Address - Fax:
Practice Address - Street 1:102 N MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5574
Practice Address - Country:US
Practice Address - Phone:336-583-3890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0305106H00000X
NC12266A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist