Individual
JAMES EARL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
105 KATHRYN DR STE D, LEWISVILLE, TX 75067-4200
(800) 972-0643
(214) 279-5032
Mailing address
4251 FM 2181 STE 230-517, CORINTH, TX 76210-4219
(800) 972-0643
(214) 279-5032
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7058
TX
101YM0800X
Mental Health Counselor
7058
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7058
LICENSE
TX
Enumeration date
12/16/2021
Last updated
12/16/2021
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