Clark, Joan
Clark, Joan is an sole proprietor health care provider with primary practice located at 949 Bridgeport Ave , Milford CT 06460-3142. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Clark, Joan can be contacted via phone (203) 878-6365.Contact Information
Primary practice address
949 Bridgeport Ave
Milford CT 06460-3142
Phone: (203) 878-6365
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 000544 | Connecticut |
Profile Details
| NPI number | 1073531166 |
|---|---|
| LBN Legal business name | Clark, Joan |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073531166 | NPPES |
| Connecticut | Other | 205652 | MANAGED HEALTH NETWORK |
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