Provider Demographics
NPI:1255119913
Name:CLEAR PATH TO WELLNESS
Entity type:Organization
Organization Name:CLEAR PATH TO WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:225-395-1037
Mailing Address - Street 1:PO BOX 1252
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-1252
Mailing Address - Country:US
Mailing Address - Phone:225-395-1037
Mailing Address - Fax:
Practice Address - Street 1:5266 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-4409
Practice Address - Country:US
Practice Address - Phone:225-635-3811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)