Crystal Clayton, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Hartford, KY

NPI 1437545993 · NPPES record last updated Apr 6, 2017

Key facts

NPI
1437545993
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
139971 (KY)
Practice address
252 Matilda LN
Hartford, KY 42347-9241
Phone
(270) 256-8293
NPI assigned
Apr 11, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
139971KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theratree, LLC. Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 139971 KY Yes

Addresses

Primary practice location

252 Matilda LN
Hartford, KY 42347-9241

Mailing address

252 Matilda LN
Hartford, KY 42347-9241

Other identifiers

IdentifierTypeStateIssuer
7100342210MedicaidKY

Other providers in Hartford, KY

All providers in Hartford, KY · Speech-Language Pathologist in Kentucky

Sources for this page

Verify at the official NPI Registry.