Individual provider · Type 1 NPI
Marybeth Clark, BS
Addiction (Substance Use Disorder) Counselor · Metropolis, IL
NPI number
1053295675
Active
Practice location
206 W 5th St
Metropolis, IL 62960-1810
Fax (618) 524-9368
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 275760 (KY) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1053295675
Marybeth Clark, BS's National Provider Identifier is 1053295675, issued on Aug 5, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Metropolis, IL. The record was last updated on Aug 5, 2025.