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Individual
LEONARD A CLARK
Active
Individual
LEONARD A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADCLAD0022409
KY
104100000X
Social Worker
1498
KY
1041C0700X
Clinical Social Worker
Primary
1498
KY
Other
Enumeration date
01/08/2007
Last updated
04/25/2019
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