Individual provider · Type 1 NPI
Bradley Clark, MA LPCC LADC
Mental Health Counselor · Lindstrom, MN
NPI number
1467112342
Active
Practice location
12814 Lake Blvd
Lindstrom, MN 55045-9345
Fax (888) 972-5307
Mailing address
PO Box 974
Lindstrom, MN 55045-0974
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 3068 (MN) |
Mental Health Counselor: Definition to come...
2 other providers at this address
Other mental health counselor providers in Lindstrom
About NPI 1467112342
Bradley Clark, MA LPCC LADC's National Provider Identifier is 1467112342, issued on Dec 20, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lindstrom, MN. The record was last updated on Dec 20, 2021.