Provider Demographics
NPI:1558800672
Name:CLEAR PATH COUNSELING, LLC
Entity Type:Organization
Organization Name:CLEAR PATH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CADC1
Authorized Official - Phone:971-334-9899
Mailing Address - Street 1:2304 E BURNSIDE ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1677
Mailing Address - Country:US
Mailing Address - Phone:971-334-9899
Mailing Address - Fax:
Practice Address - Street 1:2304 E BURNSIDE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1677
Practice Address - Country:US
Practice Address - Phone:971-334-9899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500710303Medicaid