Healthcare Provider Details

I. General information

NPI: 1740187897
Provider Name (Legal Business Name): CLEAR HARBOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2026
Last Update Date: 10/22/2026
Certification Date: 10/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 HARBOR LAKE CIR
SAFETY HARBOR FL
34695-2808
US

IV. Provider business mailing address

33 HARBOR LAKE CIR
SAFETY HARBOR FL
34695-2808
US

V. Phone/Fax

Practice location:
  • Phone: 413-218-3925
  • Fax:
Mailing address:
  • Phone: 413-218-3925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN DESLAURIERS
Title or Position: MGR
Credential: M.A., S.S.P.
Phone: 413-218-3925