Provider Demographics
NPI:1649861444
Name:CLEAR CONSULTING GROUP
Entity type:Organization
Organization Name:CLEAR CONSULTING GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRAUMA CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LSCSW
Authorized Official - Phone:816-674-2657
Mailing Address - Street 1:10109 E 63RD ST
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-5103
Mailing Address - Country:US
Mailing Address - Phone:816-533-6308
Mailing Address - Fax:
Practice Address - Street 1:10109 E 63RD ST
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-5103
Practice Address - Country:US
Practice Address - Phone:816-533-6308
Practice Address - Fax:816-662-7632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEAR CONSULTING GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-03
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1356964738Medicaid