Healthcare Provider Details

I. General information

NPI: 1093481087
Provider Name (Legal Business Name): AMBER M CLAY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 MAIN ST
CHAPMANVILLE WV
25508
US

IV. Provider business mailing address

PO BOX 4013
CHAPMANVILLE WV
25508-4013
US

V. Phone/Fax

Practice location:
  • Phone: 304-855-1222
  • Fax: 304-310-2307
Mailing address:
  • Phone: 304-855-1222
  • Fax: 304-310-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2621
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: