Individual provider · Type 1 NPI

Mary Josephine Clark, M.A., L.P.C.

Professional Counselor · Kentwood, MI

NPI number 1063482578 Active

Practice location

4835 Eastern Ave SE, Suite 102
Kentwood, MI 49508-4729

Call (616) 262-9749 Map

Fax (866) 416-7581

Mailing address

1680 44th St SE Unit 8074
Grand Rapids, MI 49518-5005

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X6401005964 (MI)

Professional Counselor: Definition to come...

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About NPI 1063482578

Mary Josephine Clark, M.A., L.P.C.'s National Provider Identifier is 1063482578, issued on Jan 25, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Kentwood, MI. The record was last updated on May 2, 2017.