Miles Anthony Clark, MFT is a
Counselor - Mental Health based in Elk, California. Miles Anthony Clark is licensed to practice in California (license number LMFT48989) and his current practice location is
34175 Philo Greenwood Rd, Elk, California. He can be reached at his office (for appointments etc.) via phone at
(707) 877-3406.
NPI number for Miles Anthony Clark is 1104399765 and his current mailing address is Po Box 77, Elk, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1104399765.
Healthcare Provider's Profile
| Full Name | Miles Anthony Clark |
|---|
| Gender | Male |
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| Speciality | Counselor - Mental Health |
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| Location | 34175 Philo Greenwood Rd, Elk, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1104399765
- Provider Enumeration Date: 01/07/2019
- Last Update Date: 01/07/2019
Medical Identifiers
Medical identifiers for Miles Anthony Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104399765 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | LMFT48989 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miles Anthony Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Miles Anthony Clark, MFT
Po Box 77,
Elk, CA 95432-0077
Ph: (707) 877-3406 | Miles Anthony Clark, MFT
34175 Philo Greenwood Rd,
Elk, CA 95432
Ph: (707) 877-3406 |
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