Melinda Brook Clarke, LMFT
Individual provider Active NPI Marriage & Family Therapist · Willits, CA
NPI 1104983618 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104983618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 41653 (CA)
- Practice address
- 104 W Mendocino Ave
Willits, CA 95490-3412 - Phone
- (707) 459-3780
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 41653 | CA | Yes |
Addresses
Primary practice location
104 W Mendocino Ave
Willits, CA 95490-3412
Mailing address
104 W Mendocino Ave
Willits, CA 95490-3412
Phone (707) 459-3780
Other providers in Willits, CA
- Care B&B Inc
- Lucia Carrillo
- Lyra Cavada
- Paul Michael Charpentier
- Janice Kathleen Cinek
- Richard James Comer
- Lori Lynn Conners
- Julia A Contreras
- County of Mendocino
- Joyce Craig
All providers in Willits, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.