Individual
JANAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHC
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
339 ARBOR RD SW, MONROE, GA 30656-8506
(404) 801-1284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC014627
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APC007673
—
GA
05
—
LPC014627
—
GA
Enumeration date
06/13/2022
Last updated
05/23/2024
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