Clark, Lisa F

Clark, Lisa F is an individual health care provider with primary practice located at 140 Bryan Blvd , Corbin KY 40701-2775. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Clark, Lisa F can be contacted via phone (606) 523-2005.

Contact Information

Primary practice address
140 Bryan Blvd Corbin KY 40701-2775
Phone: (606) 523-2005
Fax: (606) 523-9704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 247004 Kentucky

Profile Details

NPI number 1366689895
LBN Legal business name Clark, Lisa F
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 21st, 2009
Last updated Mar 12th, 2019 - about 7 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 1366689895 NPPES
Kentucky MEDICAID 7100128550

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