Individual
SHEREESE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
255 W BROADWAY, WAUKESHA, WI 53186-4832
(262) 420-9088
(262) 458-4102
Mailing address
255 W BROADWAY, WAUKESHA, WI 53186-4832
(262) 420-9088
(262) 458-4102
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15866-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16003-130
WI
Other
Enumeration date
11/09/2010
Last updated
01/21/2026
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