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Organization

CLAY POT COUNSELING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAWN E SOPRON L.C.S.W. (PRESIDENT)
(307) 752-7016
Entity
Organization

Contact information

Practice address
200 ASH ST, UNIT B, CRYSTAL LAKE, IL 60014-5956
(307) 752-7016
Mailing address
PO BOX 907, CARY, IL 60013-0907
(307) 752-7016

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW531
WY
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
314353
BLUE CROSS BLUE SHIELD
WY
01
396827550
BCBSIL
IL
01
F100698449
MEDICARE NGS
IL
Enumeration date
07/11/2006
Last updated
04/28/2025
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