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Individual
DEJANE CLARK
Active
Individual
DEJANE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC, LMHCA, SUDPT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CO61654772
WA
101YM0800X
Mental Health Counselor
APC009814
GA
101YM0800X
Mental Health Counselor
Primary
MC61654754
WA
Other
Enumeration date
08/01/2024
Last updated
02/05/2026
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