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General NPI Number Information
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NPI Number | 1528707833
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Entity Type | Organization
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Legal Business Name | THE CLARITY LOFT, PLLC
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 1910 PACIFIC AVE STE 6070
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City | DALLAS
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State | TX
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Zip | 75201-4532
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Country | US
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Telephone | 757-529-3189
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Fax |
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Provider Business Mailing Address
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Address Line | 2112 REDGATE DR
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City | SUFFOLK
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State | VA
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Zip | 23434-1003
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Country | US
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Telephone | 757-529-3189
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BENITA L THORNHILL
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Credential |
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Telephone | 757-529-3189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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