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Individual

CLARKE SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LAC

Contact information

Practice address
1016 N 1ST DR UNIT 148B, PHOENIX, AZ 85003-1455
(303) 504-7751
Mailing address
1016 N 1ST DR UNIT 148B, PHOENIX, AZ 85003-1455

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC18441
AZ
101YP2500X
Professional Counselor
Primary
20773
AZ

Other

Enumeration date
09/02/2016
Last updated
06/02/2025
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