Provider Demographics
NPI:1326699604
Name:CLARITY CLINIC LLC
Entity Type:Organization
Organization Name:CLARITY CLINIC LLC
Other - Org Name:THE CLARITY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTSIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:847-664-9593
Mailing Address - Street 1:25223 PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2076
Mailing Address - Country:US
Mailing Address - Phone:847-664-9593
Mailing Address - Fax:
Practice Address - Street 1:1725 PINECREST DR
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1624
Practice Address - Country:US
Practice Address - Phone:248-289-3109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty