Provider Demographics
NPI:1891523189
Name:CLEARMAN INTEGRATED PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:CLEARMAN INTEGRATED PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLEARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:601-480-4946
Mailing Address - Street 1:PO BOX 8191
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39303-8191
Mailing Address - Country:US
Mailing Address - Phone:601-480-4946
Mailing Address - Fax:601-621-4030
Practice Address - Street 1:3410 NORTH HILLS STREET
Practice Address - Street 2:STE B-2
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-2560
Practice Address - Country:US
Practice Address - Phone:601-480-4946
Practice Address - Fax:601-621-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty