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General NPI Number Information
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NPI Number | 1588314371
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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 | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 8 HILLVIEW DR
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-4617
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Country | US
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Telephone | 508-216-0077
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Fax | 508-507-3350
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Provider Business Mailing Address
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Address Line | 371 PUTNAM PIKE STE 230 PMB 1003
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City | SMITHFIELD
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State | RI
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Zip | 02917
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Country | US
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Telephone | 508-216-0077
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Fax | 508-507-3350
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Authorized Official
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Title or Position | OWNER
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Name | MANDY CRYSTAL BAKER
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Credential | LMHC
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Telephone | 508-216-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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