| Clear Mind Wellness Inc | |
|
532 Bloy Street Hillside NJ 07205-1734 | |
| (908) 251-9498 | |
| Not Available |
| Full Name | Clear Mind Wellness Inc |
|---|---|
| Speciality | Counselor |
| Location | 532 Bloy Street, Hillside, New Jersey |
| Authorized Official Name and Position | Heather Longergan (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9082519498 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Mind Wellness Inc 532 Bloy Street Hillside NJ 07205-1734 Ph: (908) 251-9498 | Clear Mind Wellness Inc 532 Bloy Street Hillside NJ 07205-1734 Ph: (908) 251-9498 |
| NPI Number | 1578456653 |
|---|---|
| Provider Enumeration Date | 05/29/2025 |
| Last Update Date | 05/29/2025 |
| Certification Date | 05/29/2025 |
| Medicare PECOS PAC ID | 1658882915 |
|---|---|
| Medicare Enrollment ID | O20250615000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578456653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 101YP2500X | Counselor - Professional | () | Secondary |
| Provider Name | Heather Lonergan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871863027 PECOS PAC ID: 2567973829 Enrollment ID: I20250615000044 |
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