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General NPI Number Information
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NPI Number | 1326411950
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Entity Type | Individual
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Provider Name | SHERI LYN CLARK PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 2525 E ARIZONA BILTMORE CIR STE D144
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City | PHOENIX
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State | AZ
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Zip | 85016-2105
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Country | US
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Telephone | 480-594-0422
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Fax | 855-915-0262
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Provider Business Mailing Address
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Address Line | 2001 E MARSHALL AVE
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City | PHOENIX
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State | AZ
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Zip | 85016-3110
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Country | US
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Telephone | 865-604-6772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3383
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 4678
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License Number State | AZ
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