Provider Demographics
NPI:1063861334
Name:CLEAR VIEW DEVELOPMENT
Entity Type:Organization
Organization Name:CLEAR VIEW DEVELOPMENT
Other - Org Name:MARCIA THOMPSON, LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-674-6284
Mailing Address - Street 1:1106 SCOTCH DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1523
Mailing Address - Country:US
Mailing Address - Phone:704-674-6284
Mailing Address - Fax:980-320-0301
Practice Address - Street 1:1106 SCOTCH DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1523
Practice Address - Country:US
Practice Address - Phone:704-674-6284
Practice Address - Fax:980-320-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0041111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPTAN 2853244OtherMEDICARE
NC6003070Medicaid