Clear Lake Addiction and Trauma Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CLEAR LAKE ADDICTION AND TRAUMA CENTER LLC

Practice address

504 Regency PL
Lawrenceville, NJ 08648-2576

Phone

(609) 498-9003

NPI assigned

Jul 18, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Ricardo Alvarez, LCADCNPI 1790170744

Title

Ceo

Phone

(609) 498-9003

Specialties & licenses 1

Addresses

Other names 1

• Clear Lake Addiction and Trauma Center LLc Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ricardo Alvarez

  • Counselor
  • Princeton, NJ
  • NPI 1790170744
  NPD Authorized official

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1295414001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 REGENCY PL",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482576",
            "telephone_number": "609-498-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 REGENCY PL",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482576",
            "telephone_number": "609-498-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LAKE ADDICTION AND TRAUMA CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-498-9003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Lake Addiction and Trauma Center LLc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yce Chung, M.D.
• Cindy Lou Hisle LLC (sylenes)
• Kristen Cipparone, O.D.
• Alissa A Clancey, D.C.
• Eileen J Clark, MSW, LCSW
• Clinical Behavioral Health Associates, PC
• Gale Cohen, RD, CDE
• Irene Mazal Cohen, AUD
• Shodeinde Ariyo Coker, M.D.
• Nikki Coleman

• Mental Health Clinic/Center (Including Community Mental Health Center) in Lawrenceville, NJ
• Providers in Lawrenceville, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.