Healthcare Provider Details

I. General information

NPI: 1073432431
Provider Name (Legal Business Name): CLARKE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 30TH ST SW
ROCHESTER MN
55902-1132
US

IV. Provider business mailing address

1224 EASTGATE DR SE BOX 8028
ROCHESTER MN
55904-5716
US

V. Phone/Fax

Practice location:
  • Phone: 714-906-5732
  • Fax:
Mailing address:
  • Phone: 714-906-5732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA DAY
Title or Position: CEO
Credential: LCSW, LICSW, MSW
Phone: 714-906-5732