Michelle D. Cleary, R1233040616

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1233040616 Issued in CA

Practice address

1405 11TH St
Modesto, CA 95354-0748

Phone

(209) 284-0970

NPI assigned

Jul 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1871102947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194",
            "city": "CROWS LANDING",
            "state": "CA",
            "postal_code": "953130194",
            "telephone_number": "209-210-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 11TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540748",
            "telephone_number": "209-284-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "MICHELLE",
        "middle_name": "D.",
        "credential": "R1233040616",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1233040616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton K Casey MD Inc a Professional Medical Corporation
• Heather Marie Clayton-Young, PA-C
• Susan Patricia Clayton
• Tanner Clayton
• Clear Recovery Center, LLC
• Shelby Clem
• Jeffrey Michael Clemens, ACNP
• Andrea Clemente
• Ethel Gonzales Clemente, M.D.
• Fabiola Esmeralda Clemente

• Addiction (Substance Use Disorder) Counselor in Modesto, CA
• Providers in Modesto, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.