Individual provider · Type 1 NPI
Randy W. Clark
Addiction (Substance Use Disorder) Counselor · Summerfield, FL
NPI number
1134086986
Active
Practice location
14911 SE 73rd Ave
Summerfield, FL 34491-4225
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | CAP.0100612 (FL) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1134086986
Randy W. Clark's National Provider Identifier is 1134086986, issued on Jan 5, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Summerfield, FL. The record was last updated on Feb 23, 2026.