Healthcare Provider Details

I. General information

NPI: 1255971156
Provider Name (Legal Business Name): CLER FAMILY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 08/11/2024
Certification Date: 08/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WATERFRONT CT
ALGONQUIN IL
60102
US

IV. Provider business mailing address

12 WATERFRONT CT
ALGONQUIN IL
60102
US

V. Phone/Fax

Practice location:
  • Phone: 847-503-9041
  • Fax:
Mailing address:
  • Phone: 847-503-9041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROL PETRAKIS MARTIN
Title or Position: OWNER
Credential: LCSW
Phone: 847-503-9041