Individual
BRIAN MARK CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3704 OLD FOREST RD, LYNCHBURG, VA 24501-6943
(833) 510-4357
(866) 460-2997
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003128
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945115
—
VA
01
—
105735
ANTHEM
VA
05
—
105735
—
VA
01
—
O83784
SOUTHERN HEALTH
VA
05
—
O83784
—
VA
Enumeration date
04/19/2006
Last updated
08/15/2024
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