Individual
CHARITY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
560 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5298
(208) 881-2802
Mailing address
4375 NATALIE ST, IDAHO FALLS, ID 83401-3825
(208) 201-0490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-43896
ID
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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