# VIBRANT LIFE THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043122567
- **Authorized official:** MRS. MINAH CLARK LCSW (OWNER/MENTAL HEALTH THERAPIST)
- **Authorized official phone:** (310) 488-8281

## Contact information

- **Practice address:** 2842 SHIRLEY ST, EUGENE, OR 97404-1881
- **Practice address phone:** (541) 597-9113
- **Mailing address:** 1498 E MAIN ST, STE 103 PMB 277, COTTAGE GROVE, OR 97424
- **Mailing address phone:** (541) 597-9113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/21/2026
- **Last updated:** 09/21/2026