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General NPI Number Information
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NPI Number | 1225826985
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Entity Type | Organization
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Legal Business Name | CLEAR MIND WELLNESS LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 200 MAMARONECK AVE STE 201
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City | WHITE PLAINS
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State | NY
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Zip | 10601-5315
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Country | US
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Telephone | 914-639-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MAMARONECK AVE STE 201
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City | WHITE PLAINS
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State | NY
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Zip | 10601-5315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARIN WITRIOL
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Credential |
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Telephone | 718-813-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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