Provider Demographics
NPI:1003509944
Name:CLARITY COUNSELING COLLECTIVE
Entity Type:Organization
Organization Name:CLARITY COUNSELING COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMAREST
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCS
Authorized Official - Phone:262-488-4410
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-0253
Mailing Address - Country:US
Mailing Address - Phone:252-722-9992
Mailing Address - Fax:252-862-2999
Practice Address - Street 1:714 W CORBETT AVE
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-8438
Practice Address - Country:US
Practice Address - Phone:252-722-9992
Practice Address - Fax:252-862-2999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty