Individual provider · Type 1 NPI

Connie Clark

Mental Health Counselor · Jacksonville, FL

NPI number 1528489002 Active

Practice location

620 Wellhouse Dr
Jacksonville, FL 32220-1367

Call (904) 222-1784 Map

Fax (904) 253-3001

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1528489002

Connie Clark's National Provider Identifier is 1528489002, issued on Dec 30, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jacksonville, FL. The record was last updated on Dec 30, 2013.