Provider Demographics
NPI:1700246329
Name:CLARK, BARBARA JOYCE (MED, LPCC)
Entity Type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:JOYCE
Last Name:CLARK
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1777 DAISYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-5549
Mailing Address - Country:US
Mailing Address - Phone:614-751-0042
Mailing Address - Fax:614-751-0047
Practice Address - Street 1:2238 S HAMILTON RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4382
Practice Address - Country:US
Practice Address - Phone:614-751-0042
Practice Address - Fax:614-751-0047
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1100141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health