Individual
ANGELA S CLARK
Active
Individual
ANGELA S CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
01810
IA
101YP2500X
Professional Counselor
Primary
0012011
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29021
WELLMARK BLUE SHIELD
IA
Enumeration date
07/07/2006
Last updated
11/10/2025
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