Provider Demographics
NPI:1376855742
Name:CLARKE, CHRISTOPHER PETER (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PETER
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 1:1710 WYNNWOOD LN N
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8416
Mailing Address - Country:US
Mailing Address - Phone:610-704-5553
Mailing Address - Fax:
Practice Address - Street 1:2045 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7480
Practice Address - Country:US
Practice Address - Phone:610-865-8177
Practice Address - Fax:610-865-2764
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional