Provider Demographics
NPI:1093492118
Name:CLARKSON, TERESA BERDEN (LPC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:BERDEN
Last Name:CLARKSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 SWEETBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-6654
Mailing Address - Country:US
Mailing Address - Phone:810-404-1933
Mailing Address - Fax:
Practice Address - Street 1:4040 MUSHROOM RD
Practice Address - Street 2:
Practice Address - City:SNOVER
Practice Address - State:MI
Practice Address - Zip Code:48472-9718
Practice Address - Country:US
Practice Address - Phone:810-404-1933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional