Individual
MR. CLARK LEWIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
222 WEST ST, SUITE 29F, KEENE, NH 03431-2455
(603) 357-1180
(603) 357-1185
Mailing address
222 WEST ST, SUITE 29F, KEENE, NH 03431-2455
(603) 357-1180
(603) 357-1185
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0029
NH
106H00000X
Marriage & Family Therapist
100-0000013
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30426647
—
NH
Enumeration date
03/19/2008
Last updated
02/18/2010
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