Nancy Elizabeth Clark, LCSW
Individual provider Active NPI Mental Health Counselor · Highland, CA
NPI 1811440894 · NPPES record last updated Apr 10, 2018
Key facts
- NPI
- 1811440894
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- ASW61645 (CA)
- Practice address
- 29157 Stonegate Lane
Highland, CA 92346 - Phone
- (909) 754-5702
- Fax
- (909) 748-0582
- NPI assigned
- Jul 26, 2016
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW61645 | CA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW61645 | CA | Yes |
Addresses
Primary practice location
29157 Stonegate Lane
Highland, CA 92346
Mailing address
29157 Stonegate Lane
Highland, CA 92346
Phone (909) 754-5702
Other providers in Highland, CA
- Chandra Chockalingam
- Jongyeob Choi
- Chopra Medical LLC
- Seunghwan Chung
- Kelli Anne Clark
- Terry Lee Clayville
- Michael J Coen
- Bradley A Cole
- Odeth Yadira Coloma
- Marc Kenneth Colunga
All providers in Highland, CA · Mental Health Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2018. 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.