Healthcare Provider Details

I. General information

NPI: 1619890365
Provider Name (Legal Business Name): CLEARPATH WELLNESS SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 N THOMPSON DR APT 203
MADISON WI
53704-7897
US

IV. Provider business mailing address

813 N THOMPSON DR APT 203
MADISON WI
53704-7897
US

V. Phone/Fax

Practice location:
  • Phone: 763-498-2530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AHMED MOHAMUD
Title or Position: CO OWNER
Credential:
Phone: 763-498-2530