Claycon, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CLAYCON, LLC

Practice address

5158 Stage Rd
Suite 130
Memphis, TN 38134-3116

Phone

(662) 280-5758

Fax

(662) 280-5708

NPI assigned

May 10, 2011

Organization subpart

Yes

Parent organization

CLAYCON LLC DBA: A BRIDGE TO RECOVERYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angie Garrett

Title

Office Manager

Phone

(662) 280-5758

Specialties & licenses 1

Addresses

Other names 1

• The Healing Path Program for Women Doing business as

Tax ID family

Claycon LLC3 organizations share this tax ID, including this one

Part of

Claycon LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Claycon, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Cordova, TN
  • NPI 1295005155
  NPD tax ID
• Claycon LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Southaven, MS
  • NPI 1316181365
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1124310008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8829 CENTRE ST",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712610",
            "telephone_number": "662-280-5758",
            "fax_number": "662-280-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5158 STAGE RD",
            "address_2": "SUITE 130",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381343116",
            "telephone_number": "662-280-5758",
            "fax_number": "662-280-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYCON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAYCON LLC DBA: A BRIDGE TO RECOVERY",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-280-5758"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Healing Path Program for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia Clayborn
• Theandrew Clayborn, D.D.S.
• Emma Yates Clayborne
• Shanice P Claybrooks, MS,BCBA,LBA
• Claybrothers Transportation Services
• Allison Burge Clayton, RD
• CLC of Whitehaven, LLC
• Clean, Inc.
• Clearview in - Home Healthcare Agency
• Julie Cleary Dillon, PHD, CCC-SLP

• Mental Health Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.