Individual
DEANDRA L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LCPC-C, LADC
Contact information
Practice address
250 ANDERSON ST, PORTLAND, ME 04101-2545
(207) 775-5671
(207) 871-1243
Mailing address
PO BOX 8264, PORTLAND, ME 04104-8264
(207) 939-1909
(207) 871-1243
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3715
ME
101YM0800X
Mental Health Counselor
XL2975
ME
104100000X
Social Worker
Primary
LS6308
ME
Other
Enumeration date
01/09/2007
Last updated
09/11/2025
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