Individual
DAVID MACK CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1239 76TH ST SW STE H4, BYRON CENTER, MI 49315-7921
(616) 258-6270
Mailing address
12025 HARVEST HOME DR, LOWELL, MI 49331-8890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401224555
MI
101YM0800X
Mental Health Counselor
12387
OK
101YM0800X
Mental Health Counselor
Primary
6401224555
MI
101YM0800X
Mental Health Counselor
Primary
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—
Other
Enumeration date
03/29/2016
Last updated
04/01/2026
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