Provider Demographics
NPI:1366888315
Name:CLEAR CREEK COUNSELING PLLC
Entity type:Organization
Organization Name:CLEAR CREEK COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEISHA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:ARBOGAST
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:304-637-2660
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:VALLEY HEAD
Mailing Address - State:WV
Mailing Address - Zip Code:26294-0097
Mailing Address - Country:US
Mailing Address - Phone:304-637-2660
Mailing Address - Fax:304-637-2680
Practice Address - Street 1:1500 HARRISON AVE STE 1
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3492
Practice Address - Country:US
Practice Address - Phone:304-637-2660
Practice Address - Fax:304-637-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty