Individual
RYAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LCADC
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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