Basic Information
| Provider Information | |||||||||
| NPI: | 1699938944 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLOUTIER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2710 DAISY AVENUE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165910324 | ||||||||
| FaxNumber: | 2165911243 | ||||||||
| Practice Location | |||||||||
| Address1: | 2710 DAISY AVENUE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165910324 | ||||||||
| FaxNumber: | 2165911243 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2008 | ||||||||
| LastUpdateDate: | 07/09/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | C0500269 | OH | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.