Clear Life Counseling & Testing

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CLEAR LIFE COUNSELING & TESTING

Practice address

5830 Bond St Ste 300
Cumming, GA 30040-0312

Phone

(469) 525-9670

NPI assigned

Jul 8, 2021

Last updated

Jul 8, 2021By 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

Kyrstin Jimenez, PHDNPI 1780929422

Title

Ceo

Phone

(469) 525-9670

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyrstin Anne Jimenez, PHD, LPC

  • Professional Counselor
  • Cumming, GA
  • NPI 1780929422
  NPD Authorized official

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1396316469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 BOND ST STE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 BOND ST STE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400312",
            "telephone_number": "469-525-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR LIFE COUNSELING & TESTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "KYRSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-525-9670",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1780929422",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "endpointDescription": "Client Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5830 Bond St Ste 300",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300400312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elliott Cline Clark, PHARMD.
• Melissa Clark
• Victoria Elizabeth Clark, OTR
• Jenna Clausen-Voorhees, RBT
• Clear Life Consulting LLC (Clear Life Counseling & Testing)
• Clearview Eye Care, Inc
• Cleaver Medical Group Dermatology Inc (Cleaver Medical Group Dermatology)
• Cleaver Medical Group PC (Cleaver Medical Group)
• Cleaver Medical Group Surgery Center
• Nathan Jerome Cleaver, DO

• Professional Counselor in Cumming, GA
• Providers in Cumming, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.