# CLEARWATER COOPERATIVE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184574428
- **Authorized official:** AMANDA CLEARWATER LADAC, LMHC (OWNER/COUNSELOR)
- **Authorized official phone:** (505) 217-6834

## Contact information

- **Practice address:** 1440 CALLE CIELO VIS, BERNALILLO, NM 87004-9147
- **Practice address phone:** (505) 278-0037
- **Mailing address:** 1440 CALLE CIELO VIS, BERNALILLO, NM 87004-9147
- **Mailing address phone:** (505) 278-0037

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |

## Other

- **Enumeration date:** 01/28/2026
- **Last updated:** 01/28/2026