Provider Demographics
NPI:1144668047
Name:CLARKE, JAMES (LPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CLARKE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CHURCH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-2836
Mailing Address - Country:US
Mailing Address - Phone:203-723-7777
Mailing Address - Fax:203-729-4444
Practice Address - Street 1:305 CHURCH STREET, UNIT 5
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-6528
Practice Address - Country:US
Practice Address - Phone:203-729-7777
Practice Address - Fax:203-729-4444
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor