Provider Demographics
NPI:1194367755
Name:KLARITY P.C.
Entity Type:Organization
Organization Name:KLARITY P.C.
Other - Org Name:KLARITY KETAMINE WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-822-7404
Mailing Address - Street 1:432 S EMERSON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1949
Mailing Address - Country:US
Mailing Address - Phone:843-792-4316
Mailing Address - Fax:
Practice Address - Street 1:432 S EMERSON AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1949
Practice Address - Country:US
Practice Address - Phone:843-822-7404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300033844Medicaid