Charles Sanford Clyde , LPC
Counselor - Professional • Fairview Heights, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Charles Clyde has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Charles Clyde, LPC was a registered Counselor - Professional practicing in Fairview Heights, IL. Throughout an active medical career spanning 10 years, Charles Clyde provided care at the practice location at 125 N RUBY LN until profile deactivation on 2017-11-29.
Practice Location & Contact Primary Location
125 N Ruby Ln
Fairview Heights, IL 622081926
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor - Professional in Fairview Heights, IL
Practicing in Fairview Heights, IL (9683 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 101YP2500X
Definition to come...
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Counselor - Mental Health
Licensed Clinical Professional Counselor, PLPC, CRADC
Nurse Practitioner - Psychiatric/Mental Health
Occupational Therapist
Occupational Therapist Registered & Licensed
Nurse Practitioner - Psychiatric/Mental Health
Master of Science in Nursing, ARN, Psychiatric-Mental Health Nurse Practitioner (Board Certified)
Counselor - Mental Health
Licensed Clinical Professional Counselor
Social Worker - Clinical
Licensed Clinical Social Worker
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on November 29, 2017
NPI status registered as active in NPPES database
Registered at 125 N RUBY LN, FAIRVIEW HEIGHTS, IL 622081926 (Tel: 6183984226)
Registered at 125 N RUBY LN, FAIRVIEW HEIGHTS, IL 622081926 (Tel: 6183984226)
Recorded as CHARLES CLYDE, LPC
Counselor
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
125 N Ruby Ln
Fairview Heights, IL 622081926
Phone: 6183984226
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