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
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 119 SOLOMON JAMES LN
    LONDON, KY
    ZIP 40744
  • Phone: (606) 312-1258

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NPI Details

MS. Eliza Diane Clontz, LPCC LCADC SAP CSS is a professional counselor in London, 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:

119 SOLOMON JAMES LN
LONDON, KY
ZIP 40744-192
Phone: (606) 312-1258

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/15/2024.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)165015KENTUCKYNo
2101YP2500XCounselorProfessional105747KENTUCKYYes

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
17100283130MEDICAIDKENTUCKY

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: 3/30/2025

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