Clear River Counseling and Wellness, PLLC
Organization Active NPI Counselor · Melissa, TX
NPI 1871334516 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1871334516
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- CLEAR RIVER COUNSELING AND WELLNESS, PLLC
- Practice address
- 2803 Central St.
Suite a
Melissa, TX 75454 - Phone
- (972) 265-9140
- NPI assigned
- Jun 5, 2024
- Organization subpart
- No
Authorized official
- Name
- Zach Small, MS
- Title
- Owner/President/Ceo
- Phone
- (972) 265-9140
Practitioners 2
-
Zachary Small, MA, LPC-A
-
Amanda Danyelle Brunson, MA, LPC-S
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250422000687 | TX | Part B Supplier - Clinic/Group Practice | 4486179546 |
Receives reassigned benefits from 1 practitioner Practice locations: Melissa, TX |
National Provider Directory
Locations
2803 N Central St
Ste A
Melissa, TX 75454
Phone (972) 265-9140
2803 N Central St
#100
Melissa, TX 75454
Phone (972) 265-9150
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes | ||
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Professional Counselor |
101YP2500X |
Addresses
Primary practice location
2803 Central St.
Suite a
Melissa, TX 75454
Mailing address
4109 Whitetail LN
Melissa, TX 75454-0610
Other providers in Melissa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.