Colleen Clark, LMHC
Counselor, Professional in St Petersburg, FL. Individual provider (NPI-1).
NPI number1467936799
StatusActive
Last updated in NPPESOct 25, 2021
Details
- NPI
- 1467936799
- Entity type
- Individual (NPI-1)
- Name
- Colleen Clark
- Credential
- LMHC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 22, 2018
- Certification date
- Oct 25, 2021
- Last updated
- Oct 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 15359 | FL | Yes |
Practice location
600 1st Ave N Ste 306St Petersburg, FL 33701-3609
Phone 727-283-4184
Mailing address
600 1st Ave N Ste 306St Petersburg, FL 33701-3609
Phone 727-283-4184
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