Provider Demographics
NPI:1255056560
Name:INFINITE CLARITY, LLC
Entity type:Organization
Organization Name:INFINITE CLARITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED THERAPIST/COACH, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NECHANICKY-BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT, CEC
Authorized Official - Phone:423-919-8909
Mailing Address - Street 1:3870 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHUCKEY
Mailing Address - State:TN
Mailing Address - Zip Code:37641-4954
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3870 OLD STAGE RD
Practice Address - Street 2:
Practice Address - City:CHUCKEY
Practice Address - State:TN
Practice Address - Zip Code:37641-4954
Practice Address - Country:US
Practice Address - Phone:423-919-8909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty