Healthcare Provider Details

I. General information

NPI: 1881543544
Provider Name (Legal Business Name): CLEAR PATH PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N 5TH ST
WEST MEMPHIS AR
72301-3213
US

IV. Provider business mailing address

1500 OAKLAWN DR
WEST MEMPHIS AR
72301-2996
US

V. Phone/Fax

Practice location:
  • Phone: 870-260-7902
  • Fax:
Mailing address:
  • Phone: 870-260-7902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAQUEL WILSON
Title or Position: OWNER
Credential:
Phone: 870-740-1174