Individual provider · Type 1 NPI

Susan Marie Clark, PhD

Professional Counselor · Stockbridge, GA

NPI number 1154590073 Active

Practice location

10 Wilson Rd
Stockbridge, GA 30281-4468

Call (678) 438-4225 Map

Fax (770) 506-8663

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLPC005485 (GA)
Mental Health Counselor 101YM0800XLPC005485 (GA)
Pastoral Counselor 101YP1600XLPC005485 (GA)

Professional Counselor: Definition to come...

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About NPI 1154590073

Susan Marie Clark, PhD's National Provider Identifier is 1154590073, issued on Feb 25, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Stockbridge, GA. The record was last updated on Jan 5, 2009.