Individual
SHANIKA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2620 CENTENARY BLVD STE 312, SHREVEPORT, LA 71104-3358
(318) 681-9935
Mailing address
800 SPRING ST STE 215, SHREVEPORT, LA 71101-3757
(318) 227-8390
(318) 428-2414
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
PLC10022
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/20/2016
Last updated
08/23/2024
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