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Individual

WILLIAM CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LCADC

Contact information

Practice address
209 COOPER AVENUE, SUITE 2, UPPER MONTCLAIR, NJ 07043-1850
(973) 220-9864
(973) 807-9363
Mailing address
209 COOPER AVENUE, SUITE 2, UPPER MONTCLAIR, NJ 07043-1850
(973) 220-9864
(973) 807-9363

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00186000
NJ
101YP2500X
Professional Counselor
Primary
37PC00492700
NJ

Other

Enumeration date
04/14/2014
Last updated
08/18/2016
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