Clark, Cory J

Clark, Cory J is an individual health care provider with primary practice located at 403 E 15Th St , Austin TX 78701-1437. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Clark, Cory J can be contacted via phone (512) 480-0920.

Contact Information

Primary practice address
403 E 15Th St Austin TX 78701-1437
Phone: (512) 480-0920
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11614 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 67615 Texas

Profile Details

NPI number 1780003574
LBN Legal business name Clark, Cory J
Credentials LPC, LCDC, LMFTA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2014
Last updated Apr 9th, 2014 - about 12 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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