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Individual

KATHRYN ALISON CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
535 OCEAN AVE STE 4, PORTLAND, ME 04103-4970
(207) 370-5389
Mailing address
314 ALFRED ST, BIDDEFORD, ME 04005-3102
(207) 370-5389

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC7797
ME
1041C0700X
Clinical Social Worker
Primary
MC20209
ME

Other

Enumeration date
05/05/2022
Last updated
01/08/2025
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