Organization Active NPI

A Clear Look Coaching Agency, LLC

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1487279485
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
A CLEAR LOOK COACHING AGENCY, LLC
Practice address
4582 Cumberland Rd Ste 104
Fayetteville, NC 28306-2416
Phone
(910) 747-6543
NPI assigned
Jun 15, 2020
Last updated
Dec 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Andre Brown
Title
Owner
Phone
(910) 747-6543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4582 Cumberland Rd Ste 104
Fayetteville, NC 28306-2416

Mailing address

584 Executive PL Ste 201
Fayetteville, NC 28305-5183
Phone (910) 500-3019

Other practice location 1

584 Executive Pl Ste 201
Fayetteville, NC 28305-5183
Phone (910) 500-3019

National Provider Directory

National Provider Directory
Tax ID family
A Clear Look Coaching Agency LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4582 Cumberland Rd
Ste 104
Fayetteville, NC 28306
Phone (910) 500-3019

584 Executive Pl
Ste 201
Fayetteville, NC 28305
Phone (910) 418-0777

910 Person St
Fayetteville, NC 28301

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1487279485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 EXECUTIVE PL STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055183",
            "telephone_number": "910-500-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 CUMBERLAND RD STE 104",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062416",
            "telephone_number": "910-747-6543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 Executive Pl Ste 201",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283055183",
            "country_code": "US",
            "telephone_number": "910-500-3019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "A CLEAR LOOK COACHING AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-747-6543"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.