Individual
MR. TODD ANTHONY LARK, SR. SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
935 CONTESSA DR, MURFREESBORO, TN 37128-4276
(615) 573-9089
Mailing address
935 CONTESSA DR, MURFREESBORO, TN 37128-4276
(615) 573-9089
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
000189998
TN
101YM0800X
Mental Health Counselor
000189998
TN
101YS0200X
School Counselor
Primary
000189998
TN
104100000X
Social Worker
000189998
TN
1041C0700X
Clinical Social Worker
000189998
TN
1041S0200X
School Social Worker
000189998
TN
171M00000X
Case Manager/Care Coordinator
000189998
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1503964
—
TN
Enumeration date
11/28/2018
Last updated
11/28/2018
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