Provider Demographics
NPI:1174519938
Name:MAGUIRE, CLAYTON C (LPC LMFT)
Entity type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:C
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N CENTER DR
Mailing Address - Street 2:SUITE 141
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4007
Mailing Address - Country:US
Mailing Address - Phone:757-466-0700
Mailing Address - Fax:757-461-4826
Practice Address - Street 1:420 N CENTER DR
Practice Address - Street 2:SUITE 141
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4007
Practice Address - Country:US
Practice Address - Phone:757-466-0700
Practice Address - Fax:757-461-4826
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000917101YP2500X
VA0717000048106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5409501Medicaid