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Organization
MID-AMERICA PSYCHOLOGICAL SERVICES, P. C.
Active
Organization
MID-AMERICA PSYCHOLOGICAL SERVICES, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES CLEARWATER LMSW (OWNER/PRESIDENT)
(269) 744-6138
Entity
Organization
Contact information
Practice address
8036 MOORS BRIDGE RD, SUITE 2, PORTAGE, MI 49024-4419
(269) 327-1438
(269) 327-6454
Mailing address
8036 MOORSBRIDGE RD, SUITE 2, PORTAGE, MI 49024
(269) 327-1438
(269) 327-6454
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
071800
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800C962000
BLUE CROSS
MA
Enumeration date
02/05/2007
Last updated
09/29/2025
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