Individual
KEVIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW / LCSW
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4507
(303) 763-0159
Mailing address
3167 S ACOMA ST, ENGLEWOOD, CO 80110-2411
(303) 763-0159
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09924404
CO
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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