| C Clark Llc | |
|
210 25th Ave North Suite 601, Room 13 Nashville TN 37203 | |
| (615) 337-8709 | |
| Not Available |
| Full Name | C Clark Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 210 25th Ave North, Nashville, Tennessee |
| Authorized Official Name and Position | Chanella Latre Clark (OWNER) |
| Authorized Official Contact | 6153378709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C Clark Llc 1515 5th Ave N Apt 204 Nashville TN 37208-2798 Ph: (615) 337-8709 | C Clark Llc 210 25th Ave North Suite 601, Room 13 Nashville TN 37203 Ph: (615) 337-8709 |
| NPI Number | 1316664006 |
|---|---|
| Provider Enumeration Date | 10/24/2022 |
| Last Update Date | 10/24/2022 |
| Certification Date | 10/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316664006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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