Healthcare Provider Details

I. General information

NPI: 1629533328
Provider Name (Legal Business Name): CLAY CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2019
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 VETERANS BOULEVARD SUITE 212
KENNER LA
70062-4001
US

IV. Provider business mailing address

8207 CALLAGHAN SUITE 320
SAN ANTONIO TX
78230-4737
US

V. Phone/Fax

Practice location:
  • Phone: 504-305-0600
  • Fax: 504-305-0602
Mailing address:
  • Phone: 210-601-7553
  • Fax: 210-366-9370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD C TURNER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 210-601-7553