Individual
EDWARD CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC., CCADC
Contact information
Practice address
4015 NINE MCFARLAND DR, SUITE #175, ALPHARETTA, GA 30004-8493
(678) 982-9039
(470) 235-8705
Mailing address
4015 NINE MCFARLAND DR, SUITE #175, ALPHARETTA, GA 30004-8493
(678) 982-9039
(470) 235-8705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
102L00000X
Psychoanalyst
—
—
Other
Enumeration date
05/29/2012
Last updated
08/04/2014
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