Clear Space MH, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CLEAR SPACE MH, LLC

Practice address

212 Calla St
Providence, RI 02905

Phone

(401) 376-3093

NPI assigned

Aug 12, 2022

Organization subpart

No

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

Authorized official

Name

Alicia V Rodriguez, LICSWNPI 1487206199

Title

Owner

Phone

(401) 376-3093

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Practitioners 3

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

• Alicia V Rodriguez, LICSW

  • Clinical Social Worker
  • Providence, RI
  • NPI 1487206199
  Medicare reassignment NPD Authorized official
• Lucely D Rodriguez

  • Clinical Social Worker
  • North Providence, RI
  • NPI 1093160558
  Medicare reassignment NPD
• Madibet Del Carmen Gomez, LMHC

  • Mental Health Counselor
  • Cranston, RI
  • NPI 1922545011
  Medicare reassignment

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1740918028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N MAIN ST # 1171",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045722",
            "telephone_number": "401-376-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 CALLA ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "401-376-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR SPACE MH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-376-3093",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Clarke
• Ronald E Clary Jr., D.C.
• Jessica Claus, MD
• Estefania Clavijo, LCSW
• Jessica E Clayburgh, P.T.
• Clear Voice Therapy
• Jeffrey D Clement, MD
• Melissa Lynn Clement, MSW
• Regina Clement
• Ashley Pearl Clements

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.