Individual
CLARK STILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
101 2ND AVE SE, CULLMAN, AL 35055-3511
(256) 734-4910
(256) 739-9455
Mailing address
503 CLARK ST NE, CULLMAN, AL 35055-1921
(256) 739-0801
(256) 739-0027
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1788
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51513642STI
BCBS
AL
Enumeration date
01/26/2007
Last updated
12/22/2020
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