Laura Clark Counseling, Llc | |
715 Hill St Ste 132 Madison WI 53705-3572 | |
(734) 649-9948 | |
(608) 255-9219 |
Full Name | Laura Clark Counseling, Llc |
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Speciality | Psychologist |
Location | 715 Hill St Ste 132, Madison, Wisconsin |
Authorized Official Name and Position | Laura Kathleen Clark (LICENSED PSYCHOLOGIST) |
Authorized Official Contact | 7346499948 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Laura Clark Counseling, Llc 9415 Stoneywood Blvd Middleton WI 53562-4234 Ph: (734) 649-9948 | Laura Clark Counseling, Llc 715 Hill St Ste 132 Madison WI 53705-3572 Ph: (734) 649-9948 |
NPI Number | 1437753076 |
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Provider Enumeration Date | 11/24/2020 |
Last Update Date | 11/24/2020 |
Certification Date | 11/24/2020 |
Medicare PECOS PAC ID | 7113339581 |
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Medicare Enrollment ID | O20201209002686 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437753076 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Laura Kathleen Clark |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1730458159 PECOS PAC ID: 6305009861 Enrollment ID: I20201209002727 |
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