Provider Demographics
NPI:1174195630
Name:CLARITY CENTER FOR BEHAVIORAL HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:CLARITY CENTER FOR BEHAVIORAL HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:336-257-1332
Mailing Address - Street 1:PO BOX 1954
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33595-1954
Mailing Address - Country:US
Mailing Address - Phone:336-257-1332
Mailing Address - Fax:
Practice Address - Street 1:2406 E STATE ROAD 60 # 1954
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-3707
Practice Address - Country:US
Practice Address - Phone:336-257-1332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty