Clark, Genese Calloway

Clark, Genese Calloway is an sole proprietor health care provider with primary practice located at 458 Grand Ave Ste 103 , New Haven CT 06513-3873. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Clark, Genese Calloway can be contacted via phone (203) 850-4737.

Contact Information

Primary practice address
458 Grand Ave Ste 103 New Haven CT 06513-3873
Phone: (203) 850-4737
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1124668694
LBN Legal business name Clark, Genese Calloway
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 13th, 2020
Last updated Jan 13th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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