person
Mrs. Nicole Lane Clark, LCSW
Mental Health Counselor in Shingletown, California
NPI 1467893032

Nicole Lane Clark is a Mental Health Counselor based in Redding, CA and is specialized in Mental Health. Nicole Lane Clark practices in Shingletown, CA and has the professional credentials of LCSW. The NPI Number for Nicole Lane Clark is 1467893032 and holds a License No. 91794 (California).

The current practice location address for Nicole Lane Clark is 31292 Alpine Meadows Rd, Shingletown, CA and can be reached out via phone at 530-474-3390 and via fax at 530-474-1407.

Location: 31292 Alpine Meadows Rd, Shingletown, CA, 96001-0314
person
Provider Profile Details
NPI Number
1467893032
Provider Name
Nicole Lane Clark
Credential
LCSW
Provider Entity Type
Individual
Gender
Female
Address
31292 Alpine Meadows Rd, Shingletown, CA, 96001-0314
Phone Number
530-474-3390
Fax Number
530-474-1407
Provider Enumeration Date
07/11/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
95-2633765 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
31292 Alpine Meadows Rd
City
State
Zip
96088-9462
Phone Number
530-474-3390
Fax Number
530-474-1407
person
Provider Business Mailing Address Details
Address
31292 Alpine Meadows Rd
City
State
Zip
96088-9462
Phone Number
530-474-3390
Fax Number
530-474-1407
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
91794 (California)
Definition
Definition to come...
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