Provider Demographics
NPI:1922562453
Name:CLEAR VISION COUNSELING LLC
Entity Type:Organization
Organization Name:CLEAR VISION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:502-995-3350
Mailing Address - Street 1:7160 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3718
Mailing Address - Country:US
Mailing Address - Phone:502-995-3350
Mailing Address - Fax:502-995-3384
Practice Address - Street 1:7160 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3718
Practice Address - Country:US
Practice Address - Phone:502-995-3350
Practice Address - Fax:502-995-3384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty