Healthcare Provider Details

I. General information

NPI: 1134581952
Provider Name (Legal Business Name): CLAY COUNSELING SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 BUSINESS CENTER DR STE 106
SAN BERNARDINO CA
92408-3447
US

IV. Provider business mailing address

1845 BUSINESS CENTER DR STE 106
SAN BERNARDINO CA
92408-3447
US

V. Phone/Fax

Practice location:
  • Phone: 909-804-8877
  • Fax:
Mailing address:
  • Phone: 909-804-8877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number91509
License Number StateCA

VIII. Authorized Official

Name: DR. APRIL CLAY
Title or Position: CEO
Credential:
Phone: 909-804-8877