Nicklaus Clark, LPC, LMHC

NPI #1407251408 in Gresham, Oregon

Provider Information

NPI Number: 1407251408
Entity Type: Individual
Name: Nicklaus Clark, LPC, LMHC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC, LMHC
Enumeration Date: Nov 3, 2014
Last Updated: Feb 4, 2016

Practice Location

Address: 1700 NW CIVIC DR
Address 2: SUITE 310
City: Gresham
State: Oregon
ZIP Code: 97030-3770
Phone: (503) 233-5405

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X	Primary

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