Individual
BREA O SAMUEL CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
326 STATE ROUTE 28N, NORTH CREEK, NY 12853-3903
(518) 791-2966
Mailing address
42 HUNTER BROOK LN # E, QUEENSBURY, NY 12804-5858
(929) 771-4210
(929) 771-4210
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
129463
NY
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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