Organization
ANDREA CLARK LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CLARK (OWNER)
(260) 200-3988
Entity
Organization
Contact information
Practice address
1530 VANCE AVE, FORT WAYNE, IN 46805-2246
(260) 200-3988
Mailing address
1530 VANCE AVE, FORT WAYNE, IN 46805-2246
(260) 200-3988
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/23/2023
Last updated
09/03/2025
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