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General NPI Number Information
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NPI Number | 1801514583
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Entity Type | Organization
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Legal Business Name | CLEAR LIFE RELATIONSHIP COUNSELING, LLC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 4514 251ST ST # 112
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City | LITTLE NECK
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State | NY
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Zip | 11362-1339
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Country | US
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Telephone | 347-433-0432
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Fax |
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Provider Business Mailing Address
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Address Line | 4514 251ST ST # 112
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City | LITTLE NECK
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State | NY
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Zip | 11362-1339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | CRYSTAL JO
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Credential | MA
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Telephone | 862-294-3011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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