Healthcare Provider Details

I. General information

NPI: 1306566054
Provider Name (Legal Business Name): ST. CLAIR INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 ESTATE THOMAS STE 210
ST THOMAS VI
00802-2400
US

IV. Provider business mailing address

9150 ESTATE THOMAS STE 210
ST THOMAS VI
00802-2400
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-2932
  • Fax: 706-535-3638
Mailing address:
  • Phone: 340-774-2932
  • Fax: 706-535-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JESSICA WHYTE
Title or Position: PRESIDENT
Credential: MA, LPC.
Phone: 340-774-2932