Provider Demographics
NPI:1366801813
Name:CLOUD, JAMES CHRISTOPHER (MS, QMHP, CADC I)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:CLOUD
Suffix:
Gender:M
Credentials:MS, QMHP, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1003 EAST MAIN STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504
Mailing Address - Country:US
Mailing Address - Phone:541-779-1282
Mailing Address - Fax:541-608-2888
Practice Address - Street 1:1025 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-956-4943
Practice Address - Fax:541-956-5463
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health