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General NPI Number Information
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NPI Number | 1417720467
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Entity Type | Organization
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Legal Business Name | CLAYTON & CLAYTON COUNSELING, PLLC
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 8038 MACINTOSH LN
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City | ROCKFORD
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State | IL
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Zip | 61107-5336
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Country | US
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Telephone | 815-708-7411
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Fax |
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Provider Business Mailing Address
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Address Line | 5062 ROCKROSE CT STE 78
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City | ROSCOE
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State | IL
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Zip | 61073-7797
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Country | US
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Telephone | 815-708-7411
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Fax |
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | KAYLA ANNE CLAYTON
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Credential | LCSW
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Telephone | 815-708-7411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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