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NPI Code Detail

MEDICARE: CLARK GARLAND

MEDICARE: CLARK GARLAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134099351
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARK GARLAND
Provider Business Mailing Address
First Line : 686 LESTER ST
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-5025
Country : US
Telephone Number : 573-873-6833
Fax Number :
Provider Business Practice Location Address
First Line : 686 LESTER ST
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-5025
Country : US
Telephone Number : 573-873-6833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2025
Last Update Date : 02/05/2026

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Directions to “ CLARK GARLAND ” Practice Location

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