Martha Elaine Clark, LCPC | |
1473 Ring Rd, Calumet City, IL 60409-5459 | |
(708) 862-8156 | |
Not Available |
Full Name | Martha Elaine Clark |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 1473 Ring Rd, Calumet City, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1750881611 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 178012803 (Illinois) | Primary |
Entity Name | Southlake Community Mental Health Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821081290 PECOS PAC ID: 5991600355 Enrollment ID: O20031231000117 |
Mailing Address | Practice Location Address |
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Martha Elaine Clark, LCPC 1805 Arbor Ln Apt 104, Crest Hill, IL 60403-2233 Ph: (708) 826-9094 | Martha Elaine Clark, LCPC 1473 Ring Rd, Calumet City, IL 60409-5459 Ph: (708) 862-8156 |
Ms. Laconyer Davis, MACC, LPC, NCC, CADC Counselor Medicare: Medicare Enrolled Practice Location: 1473 Ring Rd, Great Heights Family Medicine, Calumet City, IL 60409 Phone: 312-885-2195 | |
Elaine Smith, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 42 164th St, Calumet City, IL 60409 Phone: 312-388-1505 | |
Courtney K Berry, MA, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 400 Park Ave Apt 706, Calumet City, IL 60409 Phone: 630-853-3181 | |
Mrs. Sherri Lynne Swansey, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 593 Burnham Avenue, Calumet City, IL 60409 Phone: 708-832-1002 Fax: 708-832-1099 | |
Ms. Capri Adams, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6 158th Pl, Calumet City, IL 60409 Phone: 708-297-6602 | |
Hilary R Harris, Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 157th St, Calumet City, IL 60409 Phone: 708-692-3194 | |
Gloria Wright, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 61 Dogwood Ct, Calumet City, IL 60409 Phone: 708-849-8289 |