Provider Demographics
NPI:1912653403
Name:CLEAR VISION ASSESSMENT AND CONSULTING LLC
Entity Type:Organization
Organization Name:CLEAR VISION ASSESSMENT AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAECHELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:323-540-2929
Mailing Address - Street 1:9244 RAMONA ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6480
Mailing Address - Country:US
Mailing Address - Phone:323-540-2929
Mailing Address - Fax:
Practice Address - Street 1:550 E CARSON PLAZA DR STE 114
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-7349
Practice Address - Country:US
Practice Address - Phone:323-540-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA92691OtherBBS