Individual
MRS. RUSSHELE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3230 PENNSYLVANIA AVE SE, STE 213, WASHINGTON, DC 20020-3722
(202) 583-1181
(202) 583-1189
Mailing address
5038 HIL MAR DR, FORESTVILLE, MD 20747-3841
(301) 568-7376
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC3000764
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305806
AMERIGROUP
DC
Enumeration date
05/08/2007
Last updated
07/08/2007
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