MS. ELIZA DIANE CLONTZ (NPI# 1710105762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710105762 |
| Entity Type | Individual |
| Full Name | MS. ELIZA DIANE CLONTZ |
| Credential | LPCC LCADC SAP CSS |
| Practice Address |
1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701 |
| Mailing Address |
1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701-2793 |
| Practice Telephone | 6065289005 |
| Mailing Telephone | 6065289005 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
165015 | KY | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
105747 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100283130 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 130 Southern School Rd, Somerset, KY 42501 | 6066794782 | 6066771746 |
| Street Address |
1019 CUMBERLAND FALLS HWY STE B201 |
| City | CORBIN |
| State | KY |
| Zip Code | 40701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880640 | Kristie Lynn Hale | Nurse Practitioner | 521 East Cumberland Gap Parkway, Suite 1, Corbin, KY 40701 | 2020-10-29 |
| 1376014183 | Ruth Ann Thornhill | Nurse Practitioner | 521 E. Cumberland Gap Parkway #1, Corbin, KY 40701 | 2018-12-06 |
| 1770066136 | Grace Community Health Center, Inc. | Psychologist | 50 Ed Mcneel Drive, Corbin, KY 40701 | 2018-09-12 |
| 1235610353 | Linda Bales | Occupational Therapist | 112 Commonwealth Avenue, Corbin, KY 40701 | 2018-08-27 |
| 1710465398 | Holly Davina Bingham | Counselor | 1203 Amercn Grtg Card Rd, Corbin, KY 40701 | 2018-08-05 |
| 1881134914 | Angie Mossie Ledford | Nurse Practitioner | 521 Cumberland Gap Parkway #1, Corbin, KY 40701 | 2017-03-08 |
| 1669915609 | Energized Therapy | Occupational Therapist | 702 Phillips Lane, Corbin, KY 40701 | 2016-11-23 |
| 1649635293 | Debra Ann Hipsher | Counselor | 967 South Hwy 25 West, Corbin, KY 40701 | 2015-12-28 |
| 1356729438 | Sean William James | Family Medicine | 14949 N Us Highway 25 E Ste 4, Corbin, KY 40701 | 2015-05-11 |
| 1962847285 | Angela Davidson Gabbard | Dentist | 129 S. Hwy 1223, Corbin, KY 40701 | 2013-04-30 |
| Find all providers in zip 40701 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679819486 | Raymond Adison Miles | Counselor | 1 Trillium Way, Corbin, KY 40701-8727 | 2012-12-26 |
| 1366689895 | Lisa F Clark | Counselor | 140 Bryan Blvd, Corbin, KY 40701-2775 | 2009-01-21 |
| 1326250176 | Lisa Ann Smith | Counselor | 1203 American Greeting Rd, Corbin, KY 40701-4811 | 2007-05-04 |
| 1942412796 | Donna Allena Treece-paul | Counselor | 1203 American Greeting Rd, Corbin, KY 40701-4811 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578473 | Eastern Kentucky Specialties, LLC | Counselor | 1544 Winchester Ave Ste 804, Ashland, KY 41101-7931 | 2020-11-06 |
| 1124627484 | Mosaic Counseling Inc | Counselor | 2767 Veach Rd Ste D, Owensboro, KY 42303-6200 | 2020-10-19 |
| 1699382820 | Amy Brickler | Counselor | 1721 Us 31w Byp, Bowling Green, KY 42101-3030 | 2020-10-01 |
| 1063029429 | Paff Mental Health | Counselor | 236 E Reynolds Rd Ste C2, Lexington, KY 40517-1273 | 2020-09-29 |
| 1265041115 | Tamathy Henderson | Counselor | 129b Howell Dr, Elizabethtown, KY 42701-3614 | 2020-07-27 |
| 1588273866 | Amelia Neuroth | Counselor | 120 E Main St Apt 2102, Lexington, KY 40507-1352 | 2020-07-23 |
| 1922625649 | Laronica Shonta Lawson | Counselor | 17127 Piton Way, Louisville, KY 40245-5409 | 2020-06-29 |
| 1295351724 | Jonathan Yussman | Counselor | 3102 Sunfield Cir, Louisville, KY 40241-6514 | 2020-06-20 |
| 1952927592 | Michaela Henderson | Counselor | 1100 Walnut St # 52, Owensboro, KY 42301-2956 | 2020-06-19 |
| 1841811478 | Geneva Marie Drane | Counselor | 4316 Lonsdale Ave, Louisville, KY 40215-1036 | 2020-05-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.