Provider Demographics
NPI:1639757248
Name:COLLECTIVE CLARITY PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:COLLECTIVE CLARITY PSYCHOTHERAPY LLC
Other - Org Name:COLLECTIVE CLARITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL ANN
Authorized Official - Middle Name:SANTIAGO
Authorized Official - Last Name:MALIMBAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-246-2268
Mailing Address - Street 1:7318 W POST RD STE 211
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-6646
Mailing Address - Country:US
Mailing Address - Phone:702-246-2268
Mailing Address - Fax:702-331-2370
Practice Address - Street 1:7318 W POST RD STE 211
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-6646
Practice Address - Country:US
Practice Address - Phone:702-690-9163
Practice Address - Fax:702-331-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty