Mrs Nicole Lane Clark, LCSW - Counselor in Shingletown, CA

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Mrs Nicole Lane Clark, LCSW is a Counselor - Mental Health based in Shingletown, California. Mrs Nicole Lane Clark is licensed to practice in California (license number 91794) and her current practice location is 31292 Alpine Meadows Rd, Shingletown, California. She can be reached at her office (for appointments etc.) via phone at (530) 474-3390.

NPI number for Mrs Nicole Lane Clark is 1467893032 and her current mailing address is 1005 Magnolia Ave, Redding, California. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1467893032.

Contact Information

Mrs Nicole Lane Clark, LCSW
31292 Alpine Meadows Rd,
Shingletown, CA 96088-9462
(530) 474-3390
(530) 474-1407

Map and Direction


Healthcare Provider's Profile

Full NameMrs Nicole Lane Clark
GenderFemale
SpecialityCounselor - Mental Health
Location31292 Alpine Meadows Rd, Shingletown, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1467893032
  • Provider Enumeration Date: 07/11/2013
  • Last Update Date: 05/21/2021

Medical Identifiers

Medical identifiers for Mrs Nicole Lane Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467893032NPI-NPPES
95-2633765OtherCAMEDI-CAL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health 91794 (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. Mrs Nicole Lane 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 AddressPractice Location Address
Mrs Nicole Lane Clark, LCSW
1005 Magnolia Ave,
Redding, CA 96001-0314

Ph: (530) 209-5545		Mrs Nicole Lane Clark, LCSW
31292 Alpine Meadows Rd,
Shingletown, CA 96088-9462

Ph: (530) 474-3390

Reviews and Comments


Counselor in Shingletown, CA


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