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Terrell Tyrone Clark, PSS
Peer Specialist in Louisa, Kentucky
NPI 1518722305

Terrell Tyrone Clark is a Peer Specialist based in Louisa, KY. Terrell Tyrone Clark practices in Louisa, KY and has the professional credentials of PSS. The NPI Number for Terrell Tyrone Clark is 1518722305 and holds a License No. (Kentucky).

The current practice location address for Terrell Tyrone Clark is 125 S Main Cross St, Louisa, KY and can be reached out via phone at 606-639-0938.

Location: 125 S Main Cross St, Louisa, KY, 41230-1065
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518722305
Provider Name
Terrell Tyrone Clark
Credential
PSS
Provider Entity Type
Individual
Gender
Male
Address
125 S Main Cross St, Louisa, KY, 41230-1065
Phone Number
606-639-0938
Fax Number
Provider Enumeration Date
02/20/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
125 S Main Cross St
City
Louisa
State
Kentucky
Zip
41230-1065
Phone Number
606-639-0938
Fax Number
person
Provider Business Mailing Address Details
Address
125 S Main Cross St
City
Louisa
State
Kentucky
Zip
41230-1065
Phone Number
606-639-0938
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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