Clark, Vicki Lyne

Clark, Vicki Lyne is an individual health care provider with primary practice located at 12557 Ravenwood Dr , Chardon OH 44024-9009. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Clark, Vicki Lyne can be contacted via phone (440) 285-3568.

Contact Information

Primary practice address
12557 Ravenwood Dr Chardon OH 44024-9009
Phone: (440) 285-3568
Fax: (440) 285-4552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X E 0002811 Ohio
Behavioral Health & Social Service Providers / Mental Health 101YM0800X E 0002811 Ohio

Profile Details

NPI number 1184790859
LBN Legal business name Clark, Vicki Lyne
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2006
Last updated Jul 8th, 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.

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