Individual
MELINDA PACE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
70 FREEDOM LN, SCOTTSBORO, AL 35769-3763
(256) 574-5508
(256) 259-2727
Mailing address
309 TAYLOR ST, SCOTTSBORO, AL 35768-2421
(256) 259-5313
(256) 259-4923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1628C
AL
1041C0700X
Clinical Social Worker
Primary
1628C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51545900
BCBS
AL
Enumeration date
01/15/2008
Last updated
12/04/2020
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