| Clark Counseling Services Llc | |
|
360 Bloomfield Ave Suite 301 Windsor CT 06095-2700 | |
| (860) 607-3235 | |
| (860) 607-3201 |
| Full Name | Clark Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 360 Bloomfield Ave, Windsor, Connecticut |
| Authorized Official Name and Position | Matthew Clark (OWNER / PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 8606073235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Counseling Services Llc 360 Bloomfield Ave Suite 301 Windsor CT 06095-2700 Ph: (860) 607-3235 | Clark Counseling Services Llc 360 Bloomfield Ave Suite 301 Windsor CT 06095-2700 Ph: (860) 607-3235 |
| NPI Number | 1801332812 |
|---|---|
| Provider Enumeration Date | 01/13/2017 |
| Last Update Date | 01/13/2017 |
| Medicare PECOS PAC ID | 3971940032 |
|---|---|
| Medicare Enrollment ID | O20240325002430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801332812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 002674 (Connecticut) | Primary |
| Provider Name | Matthew Joseph Clark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417353996 PECOS PAC ID: 4880031947 Enrollment ID: I20240325002708 |
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