Individual
LANIKA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
(252) 946-0580
Mailing address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
(252) 946-0580
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28677
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005782
—
NC
Enumeration date
02/28/2023
Last updated
02/28/2023
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