Individual provider · Type 1 NPI
Samuel P. Clark, LMH
Mental Health Counselor · Gainesville, UM
NPI number
1265742001
Active
Practice location
1218 NW 6th Street
Gainesville, UM 32601
Fax (352) 334-3817
Mailing address
16243 SW 143rd Ave
Archer, FL 32618-4778
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | MH820 (FL) |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MH820 (FL) |
| Mental Health Counselor Primary | 101YM0800X | MH820 (FL) |
Mental Health Counselor: Definition to come...
About NPI 1265742001
Samuel P. Clark, LMH's National Provider Identifier is 1265742001, issued on Oct 14, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Gainesville, UM. The record was last updated on Oct 14, 2010.