Individual provider · Type 1 NPI

Cory J. Clark, LPC, LCDC, LMFTA

Professional Counselor · Austin, TX

NPI number 1780003574 Active

Practice location

403 E 15th St
Austin, TX 78701-1437

Call (512) 480-0920 Map

Mailing address

1430 Collier St
Austin, TX 78704-2911

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X11614 (TX)
Professional Counselor Primary 101YP2500X67615 (TX)

Professional Counselor: Definition to come...

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About NPI 1780003574

Cory J. Clark, LPC, LCDC, LMFTA's National Provider Identifier is 1780003574, issued on Apr 9, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Austin, TX. The record was last updated on Apr 9, 2014.