Eliza Diane Clontz, LPCC LCADC CSS CCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

105747 Issued in KY

Practice address

119 Solomon James LN
London, KY 40744-8192

Phone

(502) 230-7767

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Soulshine Behavioral Health

  • Mental Health Counselor
  • London, KY
  • NPI 1508719618

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1710105762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SOLOMON JAMES LN",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407448192",
            "telephone_number": "502-230-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SOLOMON JAMES LN",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407448192",
            "telephone_number": "502-230-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONTZ",
        "first_name": "ELIZA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LPCC LCADC CSS CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "165015",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "105747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100283130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicia Church, M. A. CCC/SLP
• Karen Cima
• Mary Magdaline Claridge, LMT
• Hillary Clark, APRN
• Clearpath Recovery, LLC
• Matti Ann Coffey, MDA, RD, LD
• Tara Whitney Coffey
• Kindra Lee Cole, APRN
• Lindsey Collett, PHARM D
• Cynthia Vaughn Collier

• Professional Counselor in London, KY
• Providers in London, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.