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Contact Information

BRADLEY W CLARK, LSCSW, LCAC
9333 E 21ST ST N
WICHITA, KS67206-2927
 Phone: 316-634-4700
 Fax: 316-634-4770
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for BRADLEY W CLARK · (Male)

NPI Number 1427383124
Status Active
Credentials LSCSW, LCAC
Entity Individual
Enumeration date 10/14/2009
Last updated 10/22/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers Not Available
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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