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NPI Code Detail

MEDICARE: CLEARPATH HEALTH LLC

MEDICARE: CLEARPATH HEALTH LLC
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
4363LP0808XPsychiatric/Mental Health Nurse Practitioner
5251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104406362
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEARPATH HEALTH LLC
Provider Business Mailing Address
First Line : 2963 GULF TO BAY BLVD STE 320
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-4286
Country : US
Telephone Number : 786-479-7041
Fax Number :
Provider Business Practice Location Address
First Line : 2963 GULF TO BAY BLVD STE 320
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-4286
Country : US
Telephone Number : 786-479-7041
Fax Number :
Authorized Official
Title or Position : CEO
Name : TAMARA P GLYNN
Credential : LCSW
Telephone Number : 786-479-7041
Provider Enumeration Date : 04/12/2021
Last Update Date : 02/05/2024

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Practice Location Address:
2963 GULF TO BAY BLVD STE 320
CLEARWATER, FL
33759-4286
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1467574350 — LISA M BARNES LCSW
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2963 GULF TO BAY BLVD STE 320
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1548481328 — MS. BETTY J REYNOLDS LCSW
Practice Location Address:
2963 GULF TO BAY BLVD STE 320
CLEARWATER, FL
33759-4286
Practice Phone: 727-241-8800
Practice Fax: 727-241-7050
1174168975 — ELIZABETH SHOMBERG MARCINSKI IMH
Practice Location Address:
2963 GULF TO BAY BLVD STE 320
CLEARWATER, FL
33759-4286
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Practice Fax:
1699440198 — ANGIE BEAUBRUN
Practice Location Address:
2963 GULF TO BAY BLVD STE 320
CLEARWATER, FL
33759-4286
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1619647864 — NICOLE AUSTIN
Practice Location Address:
2963 GULF TO BAY BLVD STE 320
CLEARWATER, FL
33759-4286
Practice Phone: 727-241-8800
Practice Fax:

Directions to “CLEARPATH HEALTH LLC ” Practice Location

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