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General NPI Number Information
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NPI Number | 1740899491
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Entity Type | Organization
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Legal Business Name | CLEAR THE WAY COUNSELING LLC
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 147 DURHAM RD STE 13
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City | MADISON
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State | CT
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Zip | 06443-2678
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Country | US
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Telephone | 860-575-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 446 EVERGREEN AVE
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City | HAMDEN
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State | CT
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Zip | 06518-2406
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Country | US
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Telephone | 860-575-8700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISBETH GANNON
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Credential | LPC
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Telephone | 860-575-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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