Clark, Samantha

Clark, Samantha is an individual health care provider with primary practice located at 144 E 14Th Ave Ste B , Eugene OR 97401-3533. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clark, Samantha can be contacted via phone (252) 414-4163.

Contact Information

Primary practice address
144 E 14Th Ave Ste B Eugene OR 97401-3533
Phone: (252) 414-4163
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3811 Oregon

Profile Details

NPI number 1922744465
LBN Legal business name Clark, Samantha
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2022
Last updated Apr 3rd, 2024 - about last year

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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