Individual
KENYA S CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8705 E MCDOWELL RD, SCOTTSDALE, AZ 85257-3909
(480) 882-4545
(480) 405-8929
Mailing address
3003 N CENTRAL AVE STE 400, PHOENIX, AZ 85012-2929
(602) 685-6000
(602) 302-7925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19233
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090238
—
AZ
Enumeration date
03/13/2021
Last updated
10/10/2023
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