Clear Mountain Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

071006406 Issued in IL

Legal business name

CLEAR MOUNTAIN THERAPY LLC

Practice address

1250 Executive PL
Suite 404
Geneva, IL 60134-3807

Phone

(630) 631-2180

Fax

(630) 578-0226

NPI assigned

Sep 28, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kristin Marie Anderson, PHDNPI 1245550797

Title

Psychologist/Owner

Phone

(630) 631-2180

Specialties & licenses 1

Addresses

Practitioners 2

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

• Kristin Marie Anderson, PH.D., LCP

  • Clinical Psychologist
  • Geneva, IL
  • NPI 1245550797
  NPD (past) Authorized official
• Sarah Jean Kendra, LCSW

  • Clinical Social Worker
  • Geneva, IL
  • NPI 1174131601
  NPD (past)

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475020800000",
    "number": "1376092643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 EXECUTIVE PL",
            "address_2": "SUITE 404",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343807",
            "telephone_number": "630-631-2180",
            "fax_number": "630-578-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 EXECUTIVE PL",
            "address_2": "SUITE 404",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343807",
            "telephone_number": "630-631-2180",
            "fax_number": "630-578-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR MOUNTAIN THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "630-631-2180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "071006406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alythea Claiborne, RBT
• Christine M Clark, PT
• Jessica J Clark, PA C
• Kathleen A Clark, PT
• Michelle J Clark, NPP,LPC,LCPC
• Clear Path Counseling, PLLC
• Steven Coker, M.D.
• Carson Collins, RBT
• Nicole Collins
• Community Neurologic Center SC

• Community/Behavioral Health Agency in Geneva, IL
• Providers in Geneva, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.