Basic Information
| Provider Information | |||||||||
| NPI: | 1134581952 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CLAY COUNSELING SOLUTIONS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1845 BUSINESS CENTER DR STE 106 | ||||||||
| Address2: | |||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924083447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098048877 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1845 BUSINESS CENTER DR STE 106 | ||||||||
| Address2: | |||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924083447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098048877 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 10/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | CLAY | ||||||||
| AuthorizedOfficialFirstName: | APRIL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9098048877 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 91509 | CA | N | Agencies | Community/Behavioral Health | 106H00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.