Individual provider · Type 1 NPI

Shannen Clark, COUNSELOR

Addiction (Substance Use Disorder) Counselor · Liverpool, NY

NPI number 1356980122 Active

Practice location

526 Old Liverpool Rd Ste 9
Liverpool, NY 13088-6285

Call (315) 453-3911 Map

Mailing address

147 Cumberland Ave
Syracuse, NY 13210-2211

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1356980122

Shannen Clark, COUNSELOR's National Provider Identifier is 1356980122, issued on Dec 27, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Liverpool, NY. The record was last updated on Dec 22, 2020.