Active NPI
Ethel Delois Clayton, CAC III
- Addiction (Substance Use Disorder) Counselor
- Denver, CO
National Provider Identifier
1982920484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- ACC-6626
- Practice address
- 990 Bannock St
Mc7782
Denver, CO 80204-4028 - Phone
- (720) 956-2394
- Fax
- (720) 956-2533
- NPI assigned
- Apr 9, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACC-6626 | CO | Primary |
Addresses
Primary practice location
990 Bannock St
Mc7782
Denver, CO 80204-4028
Mailing address
990 Bannock St
MC 7782
Denver, CO 80204-4028
Phone (303) 436-3536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACC-6626 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1982920484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 BANNOCK ST",
"address_2": "MC 7782",
"city": "DENVER",
"state": "CO",
"postal_code": "802044028",
"telephone_number": "303-436-3536",
"fax_number": "303-436-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 BANNOCK ST",
"address_2": "MC7782",
"city": "DENVER",
"state": "CO",
"postal_code": "802044028",
"telephone_number": "720-956-2394",
"fax_number": "720-956-2533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYTON",
"first_name": "ETHEL",
"middle_name": "DELOIS",
"credential": "CAC III",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-09",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "ACC-6626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.