Provider Demographics
NPI:1699545269
Name:CLAYTON, MEREDITH KENDRICK (LPC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:KENDRICK
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:MAE
Other - Last Name:ELLIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 YORKTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22508-5162
Mailing Address - Country:US
Mailing Address - Phone:434-249-3309
Mailing Address - Fax:
Practice Address - Street 1:311 S EAST ST
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3276
Practice Address - Country:US
Practice Address - Phone:434-249-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional