Healthcare Provider Details

I. General information

NPI: 1427383181
Provider Name (Legal Business Name): RICHARD CLAMPITT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICHARD CLAMPITT MA, LPC,

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N BUNKER HILL ST
WASILLA AK
99654-6790
US

IV. Provider business mailing address

601 BUNKER HILL ST. STE E
WASILLA AK
99654
US

V. Phone/Fax

Practice location:
  • Phone: 907-376-0776
  • Fax:
Mailing address:
  • Phone: 907-376-0776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number617
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: