Individual provider · Type 1 NPI

Celestine Clark

Mental Health Counselor · Berwyn, IL

NPI number 1679131015 Active

Practice location

6415 Stanley Ave
Berwyn, IL 60402-3130

Mailing address

8453 S Wabash Ave
Chicago, IL 60619-5615

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1679131015

Celestine Clark's National Provider Identifier is 1679131015, issued on May 31, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Berwyn, IL. The record was last updated on May 31, 2019.