Provider Demographics
NPI:1528802394
Name:CLEARLIGHT COUNSELING LLC
Entity type:Organization
Organization Name:CLEARLIGHT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARALUCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:508-560-5630
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-0124
Mailing Address - Country:US
Mailing Address - Phone:508-560-5630
Mailing Address - Fax:
Practice Address - Street 1:20 GALLO PL
Practice Address - Street 2:
Practice Address - City:VALDEZ
Practice Address - State:NM
Practice Address - Zip Code:87580
Practice Address - Country:US
Practice Address - Phone:508-560-5630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty