Individual provider · Type 1 NPI

Herman Clark, LCAS-A

Mental Health Counselor · Charlotte, NC

NPI number 1144550005 Active

Practice location

6614 Fawn View Drive
Charlotte, NC 28216

Call (704) 564-8981 Map

Mailing address

6614 Fawn View Dr
Charlotte, NC 28216-4847

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Addiction (Substance Use Disorder) Counselor 101YA0400X3196-A (NC)

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About NPI 1144550005

Herman Clark, LCAS-A's National Provider Identifier is 1144550005, issued on Dec 28, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Charlotte, NC. The record was last updated on May 7, 2014.