Provider Demographics
NPI:1124686662
Name:CLARKE, AMI (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:
Other - Last Name:COLON-TREYGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:20 CHAPEL PL
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1916
Mailing Address - Country:US
Mailing Address - Phone:718-844-9378
Mailing Address - Fax:
Practice Address - Street 1:53 MULHOLLAND DR
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-2809
Practice Address - Country:US
Practice Address - Phone:718-844-9378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health