SANDRA LOUISE CLARK NCACII LADC CCJP NPI 1306015284

NPI Information

NPI: 1306015284
Provider Name: SANDRA LOUISE CLARK, NCACII, LADC, CCJP
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1885 UNIVERSITY AVE W
SUITE 20
SAINT PAUL, MN
ZIP 55104
Phone: (651) 373-0152
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Sandra Louise Clark, NCACII, LADC, CCJP is an addiction (substance use disorder) counselor in Saint Paul, MN. Sandra Louise Clark, NCACII, LADC, CCJP NPI is 1306015284. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1885 UNIVERSITY AVE W
SUITE 20
SAINT PAUL, MN
ZIP 55104-489
Phone: (651) 373-0152
Fax: (763) 767-3145

The enumeration date for this NPI number is 2/26/2008 and was last updated on 2/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	301712	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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