person
Mr. Cory J Clark, LPC,LCDC,LMFTA
Professional Counselor in Austin, Texas
NPI 1780003574

Cory J Clark is a Professional Counselor based in Austin, TX and is specialized in Professional. Cory J Clark practices in Austin, TX and has the professional credentials of LPC,LCDC,LMFTA. The NPI Number for Cory J Clark is 1780003574 and holds a License No. 11614 (Texas).

The current practice location address for Cory J Clark is 403 E 15Th St, Austin, TX and can be reached out via phone at 512-480-0920.

Location: 403 E 15Th St, Austin, TX, 78704-2911
person
Provider Profile Details
NPI Number
1780003574
Provider Name
Cory J Clark
Credential
LPC,LCDC,LMFTA
Provider Entity Type
Individual
Gender
Male
Address
403 E 15Th St, Austin, TX, 78704-2911
Phone Number
512-480-0920
Fax Number
Provider Enumeration Date
04/09/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
403 E 15Th St
City
State
Zip
78701-1437
Phone Number
512-480-0920
Fax Number
person
Provider Business Mailing Address Details
Address
403 E 15Th St
City
State
Zip
78701-1437
Phone Number
512-480-0920
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
67615 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
11614 (Texas)
Definition
Definition to come...
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