Provider Demographics
NPI:1427826734
Name:CLARITY CLINICAL COUNSELING SERVICES
Entity type:Organization
Organization Name:CLARITY CLINICAL COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:571-251-7477
Mailing Address - Street 1:300 GARRISONVILLE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8903
Mailing Address - Country:US
Mailing Address - Phone:540-300-2096
Mailing Address - Fax:
Practice Address - Street 1:300 GARRISONVILLE RD STE 302
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8903
Practice Address - Country:US
Practice Address - Phone:540-300-2096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty