Provider Demographics
NPI:1528306339
Name:CLARK, HELEN MARIE (LPC006388)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:MARIE
Last Name:CLARK
Suffix:
Gender:F
Credentials:LPC006388
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2775 CRUSE ROAD; SUITE 702
Mailing Address - Street 2:TRILOGY COUNSELING & LEARNING CENTER
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30047
Mailing Address - Country:US
Mailing Address - Phone:404-216-9446
Mailing Address - Fax:770-982-8975
Practice Address - Street 1:2775 CRUSE ROAD
Practice Address - Street 2:SUITE 702
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30047
Practice Address - Country:US
Practice Address - Phone:404-216-9446
Practice Address - Fax:770-982-8975
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006388101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional