Healthcare Provider Details

I. General information

NPI: 1568933521
Provider Name (Legal Business Name): CLARITY COUNSELING CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 E LOCUST ST
EMMETT ID
83617-2776
US

IV. Provider business mailing address

8611 DEWEY RD
EMMETT ID
83617-8855
US

V. Phone/Fax

Practice location:
  • Phone: 208-918-0054
  • Fax: 844-696-1471
Mailing address:
  • Phone: 208-369-3724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. STEPHANIE ANN STERNES
Title or Position: CINICAL DIRECTOR
Credential: LCPC, LAMFT, NCC
Phone: 208-918-0054