Organization
RANDY CLARK LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RANDALL CLARK LPC LCADC (OWNER)
(973) 220-9864
Entity
Organization
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
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/15/2015
Last updated
08/19/2016
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