Healthcare Provider Details

I. General information

NPI: 1417888504
Provider Name (Legal Business Name): CLEAR PEAK COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 SINKING CREEK RD
PEMBROKE VA
24136-3068
US

IV. Provider business mailing address

295 SINKING CREEK RD
PEMBROKE VA
24136-3068
US

V. Phone/Fax

Practice location:
  • Phone: 540-251-2045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NATHAN CALLAHAN FOUST
Title or Position: OWNER
Credential: LPC
Phone: 540-355-8646