Clear Water Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CLEAR WATER WELLNESS LLC

Practice address

4 Park PLZ Ste 371
Wyomissing, PA 19610-1398

Phone

(610) 750-9096

NPI assigned

Oct 25, 2017

Organization subpart

No

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

Authorized official

Name

Toni L Ray, MS

Title

Member

Phone

(610) 750-9096

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1821500331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PARK PLZ STE 371",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101398",
            "telephone_number": "610-750-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PARK PLZ STE 371",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101398",
            "telephone_number": "610-750-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR WATER WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "610-750-9096",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.