Provider Demographics
NPI:1043867955
Name:CLEAR PATH COUNSELING LLC
Entity type:Organization
Organization Name:CLEAR PATH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:551-655-2503
Mailing Address - Street 1:117 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1605
Mailing Address - Country:US
Mailing Address - Phone:201-677-2106
Mailing Address - Fax:
Practice Address - Street 1:101 HUDSON ST FL 21
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3929
Practice Address - Country:US
Practice Address - Phone:201-677-2106
Practice Address - Fax:201-603-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)