Provider Demographics
NPI:1922127224
Name:AGARDY, CLARA B (LLPC)
Entity Type:Individual
Prefix:MS
First Name:CLARA
Middle Name:B
Last Name:AGARDY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2433
Mailing Address - Country:US
Mailing Address - Phone:989-773-2745
Mailing Address - Fax:
Practice Address - Street 1:218 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2514
Practice Address - Country:US
Practice Address - Phone:989-779-9449
Practice Address - Fax:989-779-2922
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009693101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401009693OtherLLPC