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General NPI Number Information
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NPI Number | 1407541543
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Entity Type | Organization
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Legal Business Name | CLEAR HEADED THERAPY
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 510 N FRONT ST
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City | WORMLEYSBURG
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State | PA
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Zip | 17043-1016
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Country | US
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Telephone | 717-606-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 8130 ADAMS DR
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City | HUMMELSTOWN
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State | PA
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Zip | 17036-8623
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Country | US
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Telephone | 717-606-3700
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | BRIAN DAVIS
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Credential |
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Telephone | 717-606-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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