Provider Demographics
NPI:1811738594
Name:CLAYPOOL, TODD ALAN (MDIV, MS KLPC, LPCA)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ALAN
Last Name:CLAYPOOL
Suffix:
Gender:M
Credentials:MDIV, MS KLPC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAIN ST STE 17
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1224
Mailing Address - Country:US
Mailing Address - Phone:502-321-9587
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN ST STE 17
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1224
Practice Address - Country:US
Practice Address - Phone:502-321-9587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY291234101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional