Clark, Nicole

Clark, Nicole is an individual health care provider with primary practice located at 125 Fairfield Way Ste 380 , Bloomingdale IL 60108-3701. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Clark, Nicole can be contacted via phone (815) 295-5470.

Contact Information

Primary practice address
125 Fairfield Way Ste 380 Bloomingdale IL 60108-3701
Phone: (815) 295-5470
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 178.014629 Illinois

Profile Details

NPI number 1891344271
LBN Legal business name Clark, Nicole
Credentials MA, LPC, NCC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2019
Last updated Sep 9th, 2019 - about 6 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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