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NPI Profile for RUSSELL CLARK in SAINT LOUIS, MO.
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Other Service Providers |
175T00000X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Community Health Worker |
172V00000X |
| NPI Number | 1659111508 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/29/2024 | |
| Last updated | 05/29/2024 - About 2 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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RUSSELL CLARK
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RUSSELL CLARK