# COURTNEY L CLARK ,LCMFT, LLC

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

## Provider details

- **NPI number:** 1144596214
- **Authorized official:** LORRY SWAYZE (BILLING MANAGER)
- **Authorized official phone:** (316) 944-3940

## Contact information

- **Practice address:** 920 N ROCK RD, DERBY, KS 67037-3552
- **Practice address phone:** (316) 788-8510
- **Practice address fax:** (316) 788-8543
- **Mailing address:** 920 N ROCK RD, DERBY, KS 67037-3552
- **Mailing address phone:** (316) 788-8510
- **Mailing address fax:** (316) 788-8543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 328 | KS | Yes |

## Other

- **Enumeration date:** 03/22/2012
- **Last updated:** 03/22/2012