Clark, Louisa Ann

Clark, Louisa Ann is an sole proprietor health care provider with primary practice located at 430 Athens St , Tarpon Springs FL 34689-3104. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Clark, Louisa Ann can be contacted via phone (727) 709-8964.

Contact Information

Primary practice address
430 Athens St Tarpon Springs FL 34689-3104
Phone: (727) 709-8964
Fax: (352) 610-9272
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH-4716 Florida

Profile Details

NPI number 1184726895
LBN Legal business name Clark, Louisa Ann
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 2nd, 2006
Last updated Nov 17th, 2011 - about 13 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 1184726895 NPPES
Florida Other 193239 AMERIGROUP
Florida Other MH-4716 AMERIGROUP
Florida Other Z020B AMERIGROUP
Florida Other 0007418288 AMERIGROUP

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