Provider Demographics
NPI:1225826985
Name:CLEAR MIND WELLNESS LLC
Entity type:Organization
Organization Name:CLEAR MIND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WITRIOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-813-2404
Mailing Address - Street 1:200 MAMARONECK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-5315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MAMARONECK AVE STE 201
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5315
Practice Address - Country:US
Practice Address - Phone:914-639-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)