Healthcare Provider Details

I. General information

NPI: 1942169313
Provider Name (Legal Business Name): CLEAR HORIZONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 CANYON LAKE DR STE 6
RAPID CITY SD
57702-2630
US

IV. Provider business mailing address

3615 CANYON LAKE DR STE 6
RAPID CITY SD
57702-2630
US

V. Phone/Fax

Practice location:
  • Phone: 605-467-7322
  • Fax: 605-997-6217
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELEISHA DOOLEY
Title or Position: CREDENTIALING
Credential:
Phone: 605-517-2444