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NPI Code Detail

MEDICARE: MS. SHERMIE F CLARK LPC, LMFT

MEDICARE: MS. SHERMIE F CLARK LPC, LMFT
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 Counselor1881LA
2106H00000XMarriage & Family Therapist115LA

General Provider Information

NPI Number : 1770552010
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHERMIE F CLARK LPC, LMFT
Provider Business Mailing Address
First Line : 1900 LAMY LN
Second Line : SUITE O
City : MONROE
State : LA
Zip : 71201-9207
Country : US
Telephone Number : 318-322-9523
Fax Number : 318-322-9213
Provider Business Practice Location Address
First Line : 1900 LAMY LN
Second Line : SUITE O
City : MONROE
State : LA
Zip : 71201-9207
Country : US
Telephone Number : 318-322-9523
Fax Number : 318-322-9213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/26/2012

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