MEDICARE: CLEARVIEW SPEECH AND CONSULTING SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	101083	TX

General Provider Information

NPI Number	:	1003276080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARVIEW SPEECH AND CONSULTING SERVICES, PLLC

Provider Business Mailing Address
First Line	:	10017 LONG RIFLE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-4154
Country	:	US
Telephone Number	:	817-692-8040
Fax Number	:

Provider Business Practice Location Address
First Line	:	10017 LONG RIFLE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-4154
Country	:	US
Telephone Number	:	817-692-8040
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	DR. NIKOSI DARNELL
Credential	:	PH.D., M.S., CCC-SLP
Telephone Number	:	817-692-8040

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	06/30/2016

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