Healthcare Provider Details

I. General information

NPI: 1497685911
Provider Name (Legal Business Name): CHRISTINA CLARK ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 WALNUT ST
GADSDEN AL
35901-4136
US

IV. Provider business mailing address

623 WALNUT ST
GADSDEN AL
35901-4136
US

V. Phone/Fax

Practice location:
  • Phone: 256-673-4346
  • Fax: 256-376-4706
Mailing address:
  • Phone: 256-673-4346
  • Fax: 256-376-4706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: