Provider Demographics
NPI:1255952313
Name:CLEAR MIND PSYCHOLOGY LTD
Entity type:Organization
Organization Name:CLEAR MIND PSYCHOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CLINICAL PAIN PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-724-2291
Mailing Address - Street 1:3440 25TH ST APT 304
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3857
Mailing Address - Country:US
Mailing Address - Phone:708-724-2291
Mailing Address - Fax:
Practice Address - Street 1:1333 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6562
Practice Address - Country:US
Practice Address - Phone:628-265-6274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health