Provider Demographics
NPI:1437970381
Name:CLEARMINDFORALL, INC
Entity type:Organization
Organization Name:CLEARMINDFORALL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ETHAN
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-202-9422
Mailing Address - Street 1:8815 CONROY WINDERMERE RD STE 628
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3129
Mailing Address - Country:US
Mailing Address - Phone:407-779-8808
Mailing Address - Fax:
Practice Address - Street 1:600 CLEVELAND ST STE 240
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4151
Practice Address - Country:US
Practice Address - Phone:917-202-9422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty