Clark, Laura L

Clark, Laura L is an individual health care provider with primary practice located at 429 Billingsley Road 2Nd Floor Mecklenburg County Substance Abuse Services Center, Charlotte NC 28211-1098. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Clark, Laura L can be contacted via phone (704) 432-0321.

Contact Information

Primary practice address
429 Billingsley Road 2Nd Floor Mecklenburg County Substance Abuse Services Center Charlotte NC 28211-1098
Phone: (704) 432-0321
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1081 North Carolina

Profile Details

NPI number 1417002551
LBN Legal business name Clark, Laura L
Credentials MS, LCAS
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1417002551 NPPES
North Carolina MEDICAID 6111895

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