Individual provider · Type 1 NPI

Ethan Clark

Mental Health Counselor · Reno, NV

NPI number 1821929324 Active

Practice location

3724 Lakeside Dr Ste 200
Reno, NV 89509-5293

Call (775) 895-0712 Map

Mailing address

1052 Watt St Apt C
Reno, NV 89509-2869

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1821929324

Ethan Clark's National Provider Identifier is 1821929324, issued on May 26, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Reno, NV. The record was last updated on May 26, 2026.