MS. ELIZA DIANE CLONTZ LPCC LCADC SAP CSS NPI 1710105762

NPI Information

NPI: 1710105762
Provider Name: MS. ELIZA DIANE CLONTZ, LPCC LCADC SAP CSS
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1019 CUMBERLAND FALLS HWY STE B201
CORBIN, KY
ZIP 40701
Phone: (606) 528-9005
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MS. Eliza Diane Clontz, LPCC LCADC SAP CSS is a professional counselor in Corbin, KY. MS. Eliza Diane Clontz, LPCC LCADC SAP CSS NPI is 1710105762. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1019 CUMBERLAND FALLS HWY STE B201
CORBIN, KY
ZIP 40701
Phone: (606) 528-9005

The enumeration date for this NPI number is 4/23/2007 and was last updated on 1/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	165015	KENTUCKY	No
2	101YP2500X	Counselor	Professional	105747	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100283130	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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