Individual
MS. STEPHANIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
600 S TAYLOR AVE, DEPT PSYCHIATRY, STE 122, SAINT LOUIS, MO 63110-1035
(314) 286-1700
(314) 970-9094
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1700
(314) 970-9094
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015045054
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490074808
—
MO
Enumeration date
02/11/2015
Last updated
04/17/2025
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