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Individual

LAWRENCE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCMHC, LCASA, LPC

Contact information

Practice address
9625 DAVID TAYLOR DR, CHARLOTTE, NC 28262-2362
(704) 387-8591
Mailing address
13814 HOLGATE HILL DR, MINT HILL, NC 28227-7507
(704) 387-8591

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS25210
NC
101YP2500X
Professional Counselor
Primary
14680
NC

Other

Enumeration date
03/05/2019
Last updated
08/06/2024
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