Healthcare Provider Details

I. General information

NPI: 1609415124
Provider Name (Legal Business Name): CLARITY COUNSELING OF THE SHOALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2019
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 S SEMINARY ST
FLORENCE AL
35630-5618
US

IV. Provider business mailing address

623 S SEMINARY ST
FLORENCE AL
35630-5618
US

V. Phone/Fax

Practice location:
  • Phone: 256-740-8322
  • Fax: 256-740-3988
Mailing address:
  • Phone: 256-740-8322
  • Fax: 256-740-3988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JEWEL MARIE WADE
Title or Position: OWNER/THERAPIST
Credential: LICSW, PIP
Phone: 256-740-8322