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Contact Information

MONICA M CLARK, MSW LISW LMFT
2102 EAST 38TH ST
DAVENPORT, IA52807
 Phone: 563-359-4049
 Fax: 563-359-4069
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for MONICA M CLARK · (Female)

NPI # 1376517045
Status Active
Credentials MSW LISW LMFT
Entity Individual
Enumeration date 02/17/2006
Last updated 09/26/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • IA License # 0821
  • IA License # 16
  • IA Medicaid 1108750000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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