Provider Demographics
NPI:1669842258
Name:DARCIE R CLARK LPCC LLC
Entity Type:Organization
Organization Name:DARCIE R CLARK LPCC LLC
Other - Org Name:RIVERSCAPE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARCIE
Authorized Official - Middle Name:RUPERT
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, NCC, LCDCIII
Authorized Official - Phone:937-671-1589
Mailing Address - Street 1:11 W MONUMENT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1293
Mailing Address - Country:US
Mailing Address - Phone:937-319-4448
Mailing Address - Fax:
Practice Address - Street 1:11 W MONUMENT AVE STE 100
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1293
Practice Address - Country:US
Practice Address - Phone:937-319-4448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0342414Medicaid
OH0320539Medicaid