Provider Demographics
NPI:1700342136
Name:CLARK, ARVID JOHN NARHI (LLMSW)
Entity Type:Individual
Prefix:
First Name:ARVID
Middle Name:JOHN NARHI
Last Name:CLARK
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7965 S NICOLET RD
Mailing Address - Street 2:
Mailing Address - City:SAULT STE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783
Mailing Address - Country:US
Mailing Address - Phone:906-630-0404
Mailing Address - Fax:
Practice Address - Street 1:605 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3111
Practice Address - Country:US
Practice Address - Phone:906-635-7270
Practice Address - Fax:906-635-7688
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011025631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical