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Organization
CLEARWATER COUNSELING CENTER LLC
Active
Organization
CLEARWATER COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ANN LANE BCD, LCSW (SOLE MBR)
(727) 417-4491
Entity
Organization
Contact information
Practice address
25400 US HIGHWAY 19 N, SUITE 172, CLEARWATER, FL 33763-2149
(727) 797-7211
Mailing address
3030 HOMESTEAD CT, CLEARWATER, FL 33759-1619
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
SW 3074
FL
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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