Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clark Hislop, SUDPT

Individual provider Counselor · NPI 1376396325

Clark Hislop, SUDPT is a Counselor in Longview, Washington. Licensed in Washington. Registered with an NPI since 2024.

Licensed in
WA
In the registry since
2024

Practice location Address checks out

748 14th Ave
Longview, WA 98632-2315
Phone: (360) 200-5419
Fax: (360) 200-6736
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence CO61454634 (WA)

Record details

NPI number1376396325
Entity typeIndividual (Type 1)
GenderMale
Credentials SUDPT
Sole proprietorNo
NPI enumeratedApril 9, 2024
Last updated in NPPESApril 9, 2024
Certification dateApril 9, 2024
Mailing addressPo Box 2394, Longview, WA 98632-8455

Other providers in Longview