Healthcare Provider Details

I. General information

NPI: 1649194762
Provider Name (Legal Business Name): CLEAR PATH MENTAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S 1ST ST STE 104
CHAMPAIGN IL
61820-6276
US

IV. Provider business mailing address

1251 S 2ND ST
LOUISVILLE KY
40203-2809
US

V. Phone/Fax

Practice location:
  • Phone: 217-996-8463
  • Fax:
Mailing address:
  • Phone: 217-714-0006
  • 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: ABIGAYL FRIELDS
Title or Position: OWNER/MANAGER
Credential: MSN, PMHNP-BC
Phone: 217-714-0006