1. Home
  2. Directory
  3. Florida
  4. Clearwater
  5. Clinic Center
  6. NPI Profile

CLEARWATER EMDR LLC
NPI 1417619446
Clinic/Center - Mental Health (Including Community Mental Health Center) in Clearwater, FL

Active since October 07, 2021
2430 ESTANCIA BLVD STE 100A, CLEARWATER, FL 33761(727) 316-5740(833) 216-5165 Get Directions Write a Review

NPPES record last updated: October 7, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Clearwater Emdr Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEARWATER EMDR LLC (NPI 1417619446) is a healthcare organization registered as a mental health (including community mental health center) in Clearwater, Florida and active in the NPI registry since October 2021. The organization lists Marie Vagedes, Owner, as its authorized official.

NPPES Registry Identity

NPI1417619446
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameCLEARWATER EMDR LLC
Location Address2430 ESTANCIA BLVD STE 100AClearwater, FL 33761-2644
Mailing Address2430 Estancia Blvd Ste 100aClearwater, FL 33761-2644 · (727) 316-5740 · Fax (833) 216-5165
Phone(727) 316-5740
Fax(833) 216-5165
Organization SubpartNo
Authorized OfficialMarie VagedesOwner · (727) 316-5740
Enumeration DateOctober 7, 2021
NPPES CertifiedOctober 7, 2021
✔ NPI 1417619446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
2430 ESTANCIA BLVD STE 100A, Clearwater, FL 33761
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clearwater Emdr Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Clearwater Emdr LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Marie Vagedes, LCSW
Clinical Social Worker
NPI 1740470236
2430 ESTANCIA BLVD STE 100A
Clearwater, FL 33761
(727) 316-5740
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clearwater Emdr LLC's NPI number?

The NPI number for Clearwater Emdr LLC is 1417619446. It was assigned to this organization in the NPPES registry on October 7, 2021.

Where is Clearwater Emdr LLC located?

Clearwater Emdr LLC is located at 2430 Estancia Blvd Ste 100A, Clearwater, FL 33761. The listed phone number is (727) 316-5740.

What is Clearwater Emdr LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Clearwater Emdr LLC enrolled in Medicare?

Yes. Clearwater Emdr LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Clearwater Emdr LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Clearwater Emdr LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Clearwater Emdr LLC was last updated on October 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.