Provider Demographics
NPI:1588314371
Name:CLEAR MIND COUNSELING LLC
Entity type:Organization
Organization Name:CLEAR MIND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-216-0077
Mailing Address - Street 1:371 PUTNAM PIKE
Mailing Address - Street 2:STE 230 PMB 1003
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917
Mailing Address - Country:US
Mailing Address - Phone:508-216-0077
Mailing Address - Fax:508-507-3350
Practice Address - Street 1:8 HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4617
Practice Address - Country:US
Practice Address - Phone:508-216-0077
Practice Address - Fax:508-507-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)