Provider Demographics
NPI:1285189324
Name:CLEARPATH HEALING ARTS CENTER
Entity Type:Organization
Organization Name:CLEARPATH HEALING ARTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SEUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:607-703-0510
Mailing Address - Street 1:3835 N FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BURDETT
Mailing Address - State:NY
Mailing Address - Zip Code:14818-9639
Mailing Address - Country:US
Mailing Address - Phone:607-703-0510
Mailing Address - Fax:607-703-0510
Practice Address - Street 1:3835 N FALLS RD
Practice Address - Street 2:
Practice Address - City:BURDETT
Practice Address - State:NY
Practice Address - Zip Code:14818-9639
Practice Address - Country:US
Practice Address - Phone:607-703-0510
Practice Address - Fax:607-703-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051452-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty