Healthcare Provider Details

I. General information

NPI: 1073994950
Provider Name (Legal Business Name): CLEAR VIEW COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 BAY RIDGE AVE STE 190
ANNAPOLIS MD
21403-2835
US

IV. Provider business mailing address

1819 BAY RIDGE AVE STE 190
ANNAPOLIS MD
21403-2835
US

V. Phone/Fax

Practice location:
  • Phone: 443-281-9430
  • Fax: 443-782-2446
Mailing address:
  • Phone: 443-281-9430
  • Fax: 443-782-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. COURTNEY K CUSACK
Title or Position: LICENSED PSYCHOLOGIST
Credential: PSY.D.
Phone: 410-281-9430