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General NPI Number Information
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NPI Number | 1518652270
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Entity Type | Organization
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Legal Business Name | CLEARPATH HEALTH LLC
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1938 DAIRY RD
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-4046
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Country | US
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Telephone | 321-574-0888
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Fax | 727-241-4499
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Provider Business Mailing Address
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Address Line | 2963 GULF TO BAY BLVD STE 320
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City | CLEARWATER
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State | FL
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Zip | 33759-4286
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Country | US
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Telephone | 727-741-8800
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Fax | 727-241-4499
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Authorized Official
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Title or Position | CEO
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Name | TAMARA P GLYNN
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Credential |
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Telephone | 727-241-7050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 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 #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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