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General NPI Number Information
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NPI Number | 1912645961
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Entity Type | Organization
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Legal Business Name | CLEAR POINT THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 05/20/2022
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 111 WOODROW WILSON DR STE A
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City | VALDOSTA
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State | GA
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Zip | 31602-2583
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Country | US
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Telephone | 469-915-4211
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Fax | 229-233-3101
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Provider Business Mailing Address
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Address Line | 111 WOODROW WILSON DR STE A
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City | VALDOSTA
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State | GA
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Zip | 31602-2583
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Country | US
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Telephone | 469-915-4211
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AL BERRY
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Credential |
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Telephone | 469-915-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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