# MARIA CLARK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maria Clark LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568949923
- **Authorized official:** MARIA CLARK MS (LIMHP)
- **Authorized official phone:** (402) 536-9568

## Contact information

- **Practice address:** 1620 WILSHIRE DR STE 222, BELLEVUE, NE 68005-6600
- **Practice address phone:** (402) 536-9568
- **Practice address fax:** (402) 905-4767
- **Mailing address:** 2613 BLACKHAWK DR, BELLEVUE, NE 68123-3707
- **Mailing address phone:** (402) 536-9568
- **Mailing address fax:** (402) 905-4767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 1579 | NE | — |
| 101YP2500X | Professional Counselor | 1579 | NE | Yes |

## Other

- **Enumeration date:** 07/27/2018
- **Last updated:** 07/27/2018