Provider Demographics
NPI:1437773736
Name:CLAYTON, ANDREW MICHAEL (LMFT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MICHAEL
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 TALMADGE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5426
Mailing Address - Country:US
Mailing Address - Phone:651-925-6714
Mailing Address - Fax:
Practice Address - Street 1:440 SCIENCE DR STE 300
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1064
Practice Address - Country:US
Practice Address - Phone:608-236-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2184-124106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist