Healthcare Provider Details

I. General information

NPI: 1467380790
Provider Name (Legal Business Name): CLEAR PATH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 W WINNEMAC AVE APT 2
CHICAGO IL
60640-2816
US

IV. Provider business mailing address

1477 W WINNEMAC AVE APT 2
CHICAGO IL
60640-2816
US

V. Phone/Fax

Practice location:
  • Phone: 312-515-8410
  • Fax:
Mailing address:
  • Phone: 312-515-8410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MOISES VENTURA
Title or Position: OWNER
Credential: LCPC, CADC
Phone: 312-515-8410