Individual
KELSEY NICOLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4407 N DIVISION ST STE 205, SPOKANE, WA 99207-1660
(509) 566-2061
(509) 566-2061
Mailing address
112 W 30TH AVE, SPOKANE, WA 99203-1719
(509) 566-2061
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60243441
WA
106H00000X
Marriage & Family Therapist
Primary
LF60878729
WA
106H00000X
Marriage & Family Therapist
MG60679997
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LF60878729
STATE LICENSING BOARD
WA
Enumeration date
04/18/2012
Last updated
08/12/2021
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