Individual
AMANDA FAYE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
124 TARA CT, BENTON, KY 42025-7513
(270) 493-1278
(270) 493-1278
Mailing address
124 TARA CT, BENTON, KY 42025-7513
(270) 493-1278
(270) 493-1278
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
303123
KY
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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