Individual
RYAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LCADC
Contact information
Practice address
1028 BARRET AVE, LOUISVILLE, KY 40204-1667
(404) 395-2355
Mailing address
3022 PETTY JAY RD, LOUISVILLE, KY 40220-2828
(404) 395-2355
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
258324
KY
1041C0700X
Clinical Social Worker
Primary
LCSW00001327
KY
Other
Enumeration date
04/01/2024
Last updated
01/28/2026
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