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Search › Idaho › 1041C0700X

Brandon Clark, LCSW

NPI 1932561115 · on the registry since 2016 · sole proprietor

Practice

Address
0309 2nd St
Lewiston, ID 83501
Phone
(208) 717-4453
Fax
(855) 564-1778
Organisation at this address
Overcomer Christian Counseling
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
1041C0700X
Licence states on file
WA, ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-10-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho