Provider Demographics
NPI:1942038484
Name:FINKELSTEIN, CLARK (MA, LPC, R-DMT)
Entity type:Individual
Prefix:
First Name:CLARK
Middle Name:
Last Name:FINKELSTEIN
Suffix:
Gender:F
Credentials:MA, LPC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 GREEN BAY RD APT B
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2240
Mailing Address - Country:US
Mailing Address - Phone:312-451-3899
Mailing Address - Fax:
Practice Address - Street 1:120 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4044
Practice Address - Country:US
Practice Address - Phone:847-668-4869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health