Provider Demographics
NPI:1578456653
Name:CLEAR MIND WELLNESS INC
Entity type:Organization
Organization Name:CLEAR MIND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGERGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:908-251-9498
Mailing Address - Street 1:532 BLOY STREET
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-1734
Mailing Address - Country:US
Mailing Address - Phone:908-251-9498
Mailing Address - Fax:
Practice Address - Street 1:532 BLOY STREET
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-1734
Practice Address - Country:US
Practice Address - Phone:908-251-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty