MEDICARE: THE CLARITY COUCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548861487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CLARITY COUCH

Provider Business Mailing Address
First Line	:	12600 ROCKSIDE RD STE 172
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-4525
Country	:	US
Telephone Number	:	216-245-8249
Fax Number	:

Provider Business Practice Location Address
First Line	:	12600 ROCKSIDE RD STE 172
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-4525
Country	:	US
Telephone Number	:	216-245-8249
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MRS. ANGELA BANKS
Credential	:	LPCC
Telephone Number	:	216-904-6729

Provider Enumeration Date	:	11/06/2020
Last Update Date	:	11/06/2020

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Directions to “THE CLARITY COUCH ” Practice Location

Language	Start Address	Practice Location

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