Provider Demographics
NPI:1699212613
Name:CLEAR VISION COUNSELING LLC
Entity Type:Organization
Organization Name:CLEAR VISION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:479-270-2806
Mailing Address - Street 1:615 N WALTON BLVD
Mailing Address - Street 2:SUITE M
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4546
Mailing Address - Country:US
Mailing Address - Phone:479-270-2806
Mailing Address - Fax:870-455-4485
Practice Address - Street 1:615 N WALTON BLVD
Practice Address - Street 2:SUITE M
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4546
Practice Address - Country:US
Practice Address - Phone:479-270-2806
Practice Address - Fax:870-455-4485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-28
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1202015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty