Provider Demographics
NPI:1982148334
Name:CLAY THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:CLAY THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUOZAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-325-1411
Mailing Address - Street 1:1325 REMINGTON RD STE O
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4815
Mailing Address - Country:US
Mailing Address - Phone:224-633-9323
Mailing Address - Fax:847-490-5342
Practice Address - Street 1:1325 REMINGTON RD STE O
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4815
Practice Address - Country:US
Practice Address - Phone:224-633-9323
Practice Address - Fax:224-512-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006912101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty