Provider Demographics
NPI:1972050086
Name:CLEAR REFLECTIONS PSYCHOL ASSOCS
Entity type:Organization
Organization Name:CLEAR REFLECTIONS PSYCHOL ASSOCS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MFT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:714-345-1236
Mailing Address - Street 1:16897 ALGONQUIN STREET
Mailing Address - Street 2:STE. L
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649
Mailing Address - Country:US
Mailing Address - Phone:714-345-1236
Mailing Address - Fax:866-357-8606
Practice Address - Street 1:16897 ALGONQUIN ST.
Practice Address - Street 2:STE L
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649
Practice Address - Country:US
Practice Address - Phone:714-345-1236
Practice Address - Fax:866-357-8606
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEAR REFLECTIONS PSYCHOL ASSOCS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
1041C0700X, 106H00000X
CAMFC43740106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty