Individual
BRANDY A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAC
Contact information
Practice address
831 DILLON DR, RICHMOND, IN 47374-8048
(765) 983-8045
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 337-2310
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001783A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87900068A
IN
Other
Enumeration date
06/25/2021
Last updated
03/09/2026
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