Doctor Name: | MR. ROBERT C CLARK |
NPI Number: | 1326489337 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.L.P.C. |
License Number: | 6401009541 |
Business Practice Address: | 913 W Holmes Rd Suite 145 Lansing, MI - 489100426 |
Business Phone Number: | 5172853332 |
Business Fax Number: | |
Mailing Address: | 730 Hunting Meadows Dr, MASON |
State: | MI |
Postal Code: | 488541429 |
Phone Number: | 5172853332 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2013 |
NPI Last Update Date: | 07/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401009541 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |