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Organization
CLARKE COUNSELING AND PSYCHOLOGICAL SERVICES
Active
Organization
CLARKE COUNSELING AND PSYCHOLOGICAL SERVICES
Active
Other names
Psychologist office
Organization subpart
No
Provider details
NPI number
Authorized official
NICKEISHA K CLARKE PSYD (PROVIDER)
(813) 445-8575
Entity
Organization
Contact information
Practice address
710 OAKFIELD DR, BRANDON, FL 33511-4938
(813) 445-8575
(813) 649-8085
Mailing address
710 OAKFIELD DR STE 153, BRANDON, FL 33511-4954
(813) 445-8575
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245710904
NPI
FL
Enumeration date
10/08/2019
Last updated
11/08/2019
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