Healthcare Provider Details

I. General information

NPI: 1134032527
Provider Name (Legal Business Name): CLEARMIND THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 RUTLEDGE ST
BROOKLYN NY
11249-7834
US

IV. Provider business mailing address

60 RUTLEDGE ST
BROOKLYN NY
11249-7834
US

V. Phone/Fax

Practice location:
  • Phone: 929-585-9342
  • Fax:
Mailing address:
  • Phone: 929-585-9342
  • Fax:

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: ABRAHAM JACOBOWITZ
Title or Position: MANAGER
Credential:
Phone: 929-585-9342