Healthcare Provider Details

I. General information

NPI: 1780260836
Provider Name (Legal Business Name): CLARITY COUNSELING AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23505 JEFFERSON AVE
SAINT CLAIR SHORES MI
48080-1968
US

IV. Provider business mailing address

23505 JEFFERSON AVE
SAINT CLAIR SHORES MI
48080-1968
US

V. Phone/Fax

Practice location:
  • Phone: 586-701-2997
  • Fax:
Mailing address:
  • Phone: 586-701-2997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN W GEORGE III
Title or Position: MEMBER
Credential: LLMSW
Phone: 586-701-2997