Clark, Christopher Tad

Clark, Christopher Tad is an sole proprietor health care provider with primary practice located at 1471 Dewar Dr Ste 204 , Rock Springs WY 82901-5826. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Clark, Christopher Tad can be contacted via phone (307) 630-3466.

Contact Information

Primary practice address
1471 Dewar Dr Ste 204 Rock Springs WY 82901-5826
Phone: (307) 630-3466
Fax: (307) 316-0228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC-1198 Wyoming
Behavioral Health & Social Service Providers / Professional 101YP2500X 1198 Wyoming

Profile Details

NPI number 1992053474
LBN Legal business name Clark, Christopher Tad
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2012
Last updated Apr 28th, 2020 - 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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