Individual
MRS. DARCIE RUPERT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC, LCDCIII
Contact information
Practice address
11 W MONUMENT AVE STE 100, DAYTON, OH 45402-1293
(937) 679-6301
(937) 630-4391
Mailing address
11 W MONUMENT AVE STE 100, DAYTON, OH 45402-1293
(937) 671-1589
(937) 435-5865
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
991819
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
E08331-5
OH
101YM0800X
Mental Health Counselor
Primary
EO8331
OH
101YP2500X
Professional Counselor
EO8331
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0184758
—
OH
Enumeration date
09/10/2009
Last updated
12/28/2020
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