Provider Demographics
NPI:1922986470
Name:CLAY COUNSELING & FAMILY THERAPY, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:CLAY COUNSELING & FAMILY THERAPY, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-804-8877
Mailing Address - Street 1:570 W 4TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1409
Mailing Address - Country:US
Mailing Address - Phone:909-804-8877
Mailing Address - Fax:
Practice Address - Street 1:570 W 4TH ST STE 210
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1409
Practice Address - Country:US
Practice Address - Phone:909-804-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-23
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health