| Leonard A Clark Lcsw Psc | |
|
200 W Lowry Ln Lexington KY 40503-3019 | |
| (859) 229-8160 | |
| (859) 276-5206 |
| Full Name | Leonard A Clark Lcsw Psc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 200 W Lowry Ln, Lexington, Kentucky |
| Authorized Official Name and Position | Larisa Yashchenko (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 5025096679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leonard A Clark Lcsw Psc 200 W Lowry Ln Lexington KY 40503-3019 Ph: (859) 229-8160 | Leonard A Clark Lcsw Psc 200 W Lowry Ln Lexington KY 40503-3019 Ph: (859) 229-8160 |
| NPI Number | 1164086013 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 04/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164086013 | NPI | - | NPPES |
| 1215085600 | Other | KY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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