# GREGORY D. CLARK, MSW, LLC

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

## Provider details

- **NPI number:** 1144600800
- **Authorized official:** MR. GREGORY DARWIN CLARK MSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (701) 799-8785

## Contact information

- **Practice address:** 118 BROADWAY N, SUITE 810, FARGO, ND 58102-4949
- **Practice address phone:** (701) 799-8785
- **Practice address fax:** (701) 205-4930
- **Mailing address:** 118 BROADWAY N, SUITE 810, FARGO, ND 58102-4949
- **Mailing address phone:** (701) 799-8785
- **Mailing address fax:** (701) 205-4930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 2973 | ND | Yes |

## Other

- **Enumeration date:** 06/08/2015
- **Last updated:** 06/01/2016