Individual
MS. ELIZA DIANE CLONTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC LCADC CSS CCS
Contact information
Practice address
119 SOLOMON JAMES LN, LONDON, KY 40744-8192
(502) 230-7767
Mailing address
119 SOLOMON JAMES LN, LONDON, KY 40744-8192
(502) 230-7767
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
165015
KY
101YP2500X
Professional Counselor
Primary
105747
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100283130
—
KY
Enumeration date
04/23/2007
Last updated
02/17/2026
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