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Individual
LOUISA ANN CLARK
Active
Individual
LOUISA ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH-4716
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007418288
AETNA
FL
01
—
193239
AMERIGROUP
FL
01
—
MH-4716
LMHC LICENSE #
FL
01
—
Z020B
BCBS FL
FL
Enumeration date
09/02/2006
Last updated
11/17/2011
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