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Organization

CLARK & CLARK COUNSELING CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUSAN M CLARK LPC (DOCTOR/OWNER)
(678) 438-4225
Entity
Organization

Contact information

Practice address
10 WILSON RD, SUITE 9, STOCKBRIDGE, GA 30281-4468
(678) 438-4225
(678) 272-6295
Mailing address
10 WILSON RD, SUITE 9, STOCKBRIDGE, GA 30281-4468
(678) 438-4225
(678) 272-6295

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC005485
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143387363A
GA
Enumeration date
09/10/2012
Last updated
09/10/2012
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