Healthcare Provider Details

I. General information

NPI: 1497934608
Provider Name (Legal Business Name): CLEAR SYNOPSIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3770 MARSHLANE WAY
RALEIGH NC
27610-4279
US

IV. Provider business mailing address

3770 MARSHLANE WAY
RALEIGH NC
27610-4279
US

V. Phone/Fax

Practice location:
  • Phone: 919-662-3703
  • Fax: 919-662-3703
Mailing address:
  • Phone: 919-662-3703
  • Fax: 919-662-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. QIANA SUTTON HARVEY
Title or Position: DIRECTOR/CEO
Credential:
Phone: 919-662-3703