Clark, Helen Yolanda

Clark, Helen Yolanda is an sole proprietor health care provider with primary practice located at 223 1St St , Moncks Corner SC 29461-3726. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clark, Helen Yolanda can be contacted via phone (843) 761-5707.

Contact Information

Primary practice address
223 1St St Moncks Corner SC 29461-3726
Phone: (843) 761-5707
Fax: (843) 899-2184
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 410155 South Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 606 South Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2212 South Carolina
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 193 South Carolina

Profile Details

NPI number 1326099706
LBN Legal business name Clark, Helen Yolanda
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2006
Last updated Jul 19th, 2013 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1326099706 NPPES
South Carolina MEDICAID QM0260

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