Provider Demographics
NPI:1962547273
Name:CLAYTON, STACEY DENISE (LCSW)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:DENISE
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 WASHINGTON ST STE C6
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7582
Mailing Address - Country:US
Mailing Address - Phone:732-575-7341
Mailing Address - Fax:
Practice Address - Street 1:252 WASHINGTON ST STE C6
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7582
Practice Address - Country:US
Practice Address - Phone:848-251-2462
Practice Address - Fax:848-251-2461
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL051412001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical