Healthcare Provider Details

I. General information

NPI: 1912585977
Provider Name (Legal Business Name): CLEAR VIEW COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 06/05/2021
Certification Date: 06/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 FOSSIL LN
SUMTER SC
29153-9519
US

IV. Provider business mailing address

2625 FOSSIL LN
SUMTER SC
29153-9519
US

V. Phone/Fax

Practice location:
  • Phone: 803-316-3880
  • Fax:
Mailing address:
  • Phone: 803-316-3880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA NICKENS MCBRIDE
Title or Position: OWNER
Credential: BA, MPA, MED
Phone: 803-316-3880