=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255222477
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLARITY BEACON PSYCHOLOGY GROUP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2025
-----------------------------------------------------
Last Update Date | 01/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 42 MARINERS CV
-----------------------------------------------------
City | EDGEWATER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07020-1293
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-407-3441
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 42 MARINERS CV
-----------------------------------------------------
City | EDGEWATER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07020-1293
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-407-3441
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. LESIA RUGLASS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-407-3441
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------