Clear Reflections Psychotherapy PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

CLEAR REFLECTIONS PSYCHOTHERAPY PLLC

Practice address

225 S Main St Ste C
Brooklyn, MI 49230-9158

Phone

(517) 414-0065

NPI assigned

Mar 7, 2020

Last updated

Mar 7, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Traci Breniser Wilson, MA LLP

Title

Psychotherapist

Phone

(517) 414-0065

Specialties & licenses 1

Addresses

Other names 1

• Clear Reflections Former legal business name

Electronic endpoints 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583539200000",
    "number": "1164057436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NICOLE DR",
            "city": "BROOKLYN",
            "state": "MI",
            "postal_code": "492309379",
            "telephone_number": "517-414-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MAIN ST STE C",
            "city": "BROOKLYN",
            "state": "MI",
            "postal_code": "492309158",
            "telephone_number": "517-414-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR REFLECTIONS PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "BRENISER",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "517-414-0065",
        "authorized_official_credential": "MA LLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "traci@traci-wilson.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "225 S Main St Ste C",
            "city": "Brooklyn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492309158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Traci@traci-wilson.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "225 S Main St Ste C",
            "city": "Brooklyn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492309158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clear Reflections",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Storm A Caryl
• Rachel Celeskey
• Chelsea Professional Services (SJMGC Dr Cole)
• Guy Young Cheng, DC
• Michael Dean Childs, DC
• Cole Family Practice P C
• Francine Cimino Cole, D.O.
• Raymond E. Cole, D.O.
• Lindsey Marie Conner, PHARMD
• Angelique M Cook

• Psychologist in Brooklyn, MI
• Providers in Brooklyn, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.