Clark, Tara Lynn

Clark, Tara Lynn is an individual health care provider with primary practice located at 3539 Dianna Way , Wenatchee WA 98801-9142. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Clark, Tara Lynn can be contacted via phone (509) 334-7123.

Contact Information

Primary practice address
3539 Dianna Way Wenatchee WA 98801-9142
Phone: (509) 334-7123
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SC60863365 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LH61072662 Washington

Profile Details

NPI number 1376853762
LBN Legal business name Clark, Tara Lynn
Credentials LMHC, LSWAIC, MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2010
Last updated Jul 31st, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1376853762 NPPES
Washington MEDICAID 2102809

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