Clark, Monica Mary

Clark, Monica Mary is an sole proprietor health care provider with primary practice located at 2102 East 38Th St , Davenport IA 52807. She recently has 2 registered licenses in different health care specialties including 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, Monica Mary can be contacted via phone (563) 359-4049.

Contact Information

Primary practice address
2102 East 38Th St Davenport IA 52807
Phone: (563) 359-4049
Fax: (563) 359-4069
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0821 Iowa
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 16 Iowa

Profile Details

NPI number 1376517045
LBN Legal business name Clark, Monica Mary
Credentials MSW LISW LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2006
Last updated Sep 26th, 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 1376517045 NPPES
Iowa MEDICAID 1108750000

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