Clearfire LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CLEARFIRE LLC

Practice address

1904 W Parkside LN
Phoenix, AZ 85027-1228

Phone

(480) 757-5885

NPI assigned

Aug 28, 2024

Organization subpart

No

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

Authorized official

Name

Micaela Wamboldt

Title

LPC

Phone

(480) 757-5885

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1861226342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13353 W LARIAT LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835973",
            "telephone_number": "480-757-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 W PARKSIDE LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271228",
            "telephone_number": "480-757-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARFIRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "WAMBOLDT",
        "authorized_official_first_name": "MICAELA",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "480-757-5885"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kevin W. Cleary, D.O.
• Aaron James Cleavenger, RN
• Patricia Anne Clees
• Karen Rudel Cleeves-Estabrook, OTR/L

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.