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General NPI Number Information
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NPI Number | 1366277972
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Entity Type | Organization
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Legal Business Name | CLEAR MIND COUNSELING LLC
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 26 SCHOOL ST
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City | YARMOUTH
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State | ME
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Zip | 04096-4709
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Country | US
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Telephone | 207-332-9462
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Fax |
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Provider Business Mailing Address
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Address Line | 26 SCHOOL ST
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City | YARMOUTH
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State | ME
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Zip | 04096-4709
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Country | US
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Telephone | 207-332-9462
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER ROSS
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Credential | LCPC, LADC, CCS
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Telephone | 207-332-9462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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