Organization
CLAYTON WILSON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAYTON WILSON LCSW (SOLE MEMBER)
(734) 395-3298
Entity
Organization
Contact information
Practice address
2701 N MILDRED AVE APT 3A, CHICAGO, IL 60614-1407
(734) 395-3298
Mailing address
2701 N MILDRED AVE APT 3A, CHICAGO, IL 60614-1407
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/10/2024
Last updated
03/18/2025
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