Individual
CHANELLA LATRE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
210 25TH AVE N STE 601, NASHVILLE, TN 37203-1631
(615) 337-8709
Mailing address
1515 5TH AVE N APT 204, NASHVILLE, TN 37208-2798
(615) 337-8709
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
281173
KY
101YP2500X
Professional Counselor
Primary
6242
TN
Other
Enumeration date
04/22/2019
Last updated
04/29/2026
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