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General NPI Number Information
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NPI Number | 1467947549
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Entity Type | Individual
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Provider Name | VANESSA CLARK
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Gender | Female
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1485 W WARM SPRINGS RD
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City | HENDERSON
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State | NV
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Zip | 89014-7631
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Country | US
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Telephone | 725-232-1991
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Fax |
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Provider Business Mailing Address
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Address Line | 500 E WARM SPRINGS RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89119-4345
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CI3017
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License Number State | NV
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