Provider Demographics
NPI:1154102614
Name:CLARITY PSYCHOLOGICAL TESTING PLCC
Entity type:Organization
Organization Name:CLARITY PSYCHOLOGICAL TESTING PLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-351-4460
Mailing Address - Street 1:881 BENT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-8253
Mailing Address - Country:US
Mailing Address - Phone:310-351-4460
Mailing Address - Fax:
Practice Address - Street 1:12627 SAN JOSE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8639
Practice Address - Country:US
Practice Address - Phone:904-736-2736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty