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NPI Code Detail

MEDICARE: MS. LINDA DIANE CLARKE M.S.

MEDICARE: MS. LINDA DIANE CLARKE M.S.
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
1101YP2500XProfessional CounselorLCPC #117KS

General Provider Information

NPI Number : 1235269762
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA DIANE CLARKE M.S.
Provider Business Mailing Address
First Line : 1879 ROAD M
Second Line :
City : EMPORIA
State : KS
Zip : 66801-7962
Country : US
Telephone Number : 620-342-3033
Fax Number :
Provider Business Practice Location Address
First Line : 901 S HAVERHILL RD
Second Line : 317 W. DORM
City : EL DORADO
State : KS
Zip : 67042-3225
Country : US
Telephone Number : 316-322-3162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ MS. LINDA DIANE CLARKE M.S.” Practice Location

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