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General NPI Number Information
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NPI Number | 1427839414
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Entity Type | Organization
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Legal Business Name | CLEAR MINDSET COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 5423 VILLAGE DR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-6570
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Country | US
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Telephone | 321-298-2376
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Fax |
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Provider Business Mailing Address
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Address Line | 675 ATZ RD
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City | MALABAR
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State | FL
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Zip | 32950-3628
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Country | US
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Telephone | 321-298-2376
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Fax |
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Authorized Official
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Title or Position | VP
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Name | TRACY MORIN
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Credential | MS, LCSW
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Telephone | 321-677-6463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 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 #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 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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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #8
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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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Taxonomy #9
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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 #10
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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 #11
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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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