Provider Demographics
NPI:1376889006
Name:ELIZABETH A. CLARKE, LPC LLC
Entity Type:Organization
Organization Name:ELIZABETH A. CLARKE, LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:908-200-5683
Mailing Address - Street 1:24 MINE ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-6500
Mailing Address - Country:US
Mailing Address - Phone:908-200-5683
Mailing Address - Fax:
Practice Address - Street 1:24 MINE ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-6500
Practice Address - Country:US
Practice Address - Phone:908-200-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00320800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health