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General NPI Number Information
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NPI Number | 1104341999
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Entity Type | Organization
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Legal Business Name | CLARITY CLINIC ARLINGTON HEIGHTS, LLC
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 2101 S ARLINGTON HEIGHTS RD STE 116
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-4142
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Country | US
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Telephone | 312-929-2172
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Fax | 312-754-9402
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Provider Business Mailing Address
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Address Line | 2101 S ARLINGTON HEIGHTS RD STE 116
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-4142
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Country | US
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Telephone | 312-929-2172
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Fax | 312-754-9402
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Authorized Official
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Title or Position | CEO
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Name | PAVAN YARLAGADDARAGHU PRASAD
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Credential | MD
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Telephone | 248-872-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 036137175
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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