Organization
A CLEAN MIND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY P PENNEWILL LCSW (OWNER)
(850) 501-1150
Entity
Organization
Contact information
Practice address
605 E GOVERNMENT ST, #C, PENSACOLA, FL 32502-8104
(850) 501-1150
Mailing address
1610 E WRIGHT ST, PENSACOLA, FL 32501-4354
(850) 501-1150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW11608
FL
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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