Provider Demographics
NPI:1467937094
Name:CLARITY THERAPY CENTER LLC
Entity Type:Organization
Organization Name:CLARITY THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCDONALD-CONROY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:608-769-1002
Mailing Address - Street 1:200 MASON ST STE 11
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-7061
Mailing Address - Country:US
Mailing Address - Phone:608-765-5501
Mailing Address - Fax:
Practice Address - Street 1:200 MASON ST STE 11
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-7061
Practice Address - Country:US
Practice Address - Phone:608-765-5501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-29
Last Update Date:2018-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty