Healthcare Provider Details

I. General information

NPI: 1679449839
Provider Name (Legal Business Name): CLEAR MIND PSYCHIATRIC ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 BAYVILLE AVE
BAYVILLE NJ
08721-1050
US

IV. Provider business mailing address

245 BAYVILLE AVE
BAYVILLE NJ
08721-1050
US

V. Phone/Fax

Practice location:
  • Phone: 469-530-4932
  • Fax: 856-283-2821
Mailing address:
  • Phone: 469-530-4932
  • Fax: 856-283-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ADEBAYO AROWOLO
Title or Position: OWNER
Credential:
Phone: 469-530-4932