Ellen Estelle Clark, LCDC
Ellen Estelle Clark, LCDC is an Undefined Non-Physician Type (Specify) in Houston, Texas. Qualified in 2009, 17 years ago. Practices as a sole proprietor. Licensed in Texas.
- Years since qualifying
- 17
- Licensed in
- TX
- In the registry since
- 2021
Practice location Address checks out
1700 Post Oak Blvd Ste 600Houston, TX 77056-3973
Phone: (800) 892-2695
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence 12293 (TX) |
|---|
Record details
| NPI number | 1528725660 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | LCDC |
| Sole proprietor | Yes |
| NPI enumerated | November 23, 2021 |
| Last updated in NPPES | January 10, 2024 |
| Certification date | January 10, 2024 |
Medicare enrollment
| Medicare specialty | UNDEFINED NON-PHYSICIAN TYPE (SPECIFY) |
|---|---|
| Medical school | OTHER |
| Graduated | 2009 (17 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |
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