Healthcare Provider Details

I. General information

NPI: 1205439411
Provider Name (Legal Business Name): LUCID AWAKENING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N EL DORADO PL # F640
TUCSON AZ
85715-4637
US

IV. Provider business mailing address

1200 N EL DORADO PL # F640
TUCSON AZ
85715-4637
US

V. Phone/Fax

Practice location:
  • Phone: 720-316-9255
  • Fax: 520-210-5729
Mailing address:
  • Phone: 720-316-9255
  • Fax: 520-210-5729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE CLAWLEY
Title or Position: OWNER AND THERAPIST
Credential: LPC
Phone: 720-316-9255