Individual provider · Type 1 NPI

Leslie A. Clark, LPC, CSAC, CIR, ICS-

Mental Health Counselor · Oak Creek, WI

NPI number 1497092704 Active

Practice location

7071 S. 13th Street, Suite 100
Oak Creek, WI 53154

Call (414) 367-6698 Map

Mailing address

11011 W. North Ave., APT.309
Wauwatosa, WI 53226

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X16215-132 (WI)
Social Worker 104100000X1180-226 (WI)
Mental Health Counselor Primary 101YM0800X5204-125 (WI)

Mental Health Counselor: Definition to come...

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About NPI 1497092704

Leslie A. Clark, LPC, CSAC, CIR, ICS-'s National Provider Identifier is 1497092704, issued on Jan 7, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Oak Creek, WI. The record was last updated on Apr 17, 2024.