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General NPI Number Information
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NPI Number | 1184591547
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Entity Type | Organization
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Legal Business Name | CLEVER CRAFT THERAPY PLLC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 2514 SHENANDOAH AVE
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City | DURHAM
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State | NC
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Zip | 27704-4260
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Country | US
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Telephone | 919-302-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 2514 SHENANDOAH AVE
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City | DURHAM
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State | NC
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Zip | 27704-4260
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Country | US
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Telephone | 919-302-1168
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | DEVON CHUBB PELTO
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Credential | LCSWA, LCASA
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Telephone | 919-302-1168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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