A Clearer Mind LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

149.015920 Issued in IL

Legal business name

A CLEARER MIND LLC

Practice address

110 E Schiller St Ste 252
Elmhurst, IL 60126-2858

Phone

(858) 945-5074

NPI assigned

Jan 6, 2017

Last updated

Jan 6, 2017By 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

Kristine Hudzik, LCSW

Title

Therapist

Phone

(858) 945-5074

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1740726330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E SCHILLER ST STE 252",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262858",
            "telephone_number": "858-945-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E SCHILLER ST STE 252",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262858",
            "telephone_number": "858-945-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CLEARER MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "HUDZIK",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "858-945-5074",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.015920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.