Provider Demographics
NPI:1366654907
Name:GUTHRIE, CLAYTON SIMS (PSYD)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:SIMS
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 4TH AVE
Mailing Address - Street 2:5G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5236
Mailing Address - Country:US
Mailing Address - Phone:917-207-3157
Mailing Address - Fax:
Practice Address - Street 1:80 UNIVERSITY PL
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4564
Practice Address - Country:US
Practice Address - Phone:212-844-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014036-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical