Provider Demographics
NPI:1528878071
Name:CLEAR MIND COACHING LLC
Entity type:Organization
Organization Name:CLEAR MIND COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-755-8759
Mailing Address - Street 1:146 BURNT HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-8745
Mailing Address - Country:US
Mailing Address - Phone:626-755-8759
Mailing Address - Fax:
Practice Address - Street 1:146 BURNT HEMLOCK RD
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-8745
Practice Address - Country:US
Practice Address - Phone:626-755-8759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health