Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Fanchon Marie Clark, MA, LPC, CAADC

Individual provider Professional Counselor · NPI 1689190290

Fanchon Marie Clark, MA, LPC, CAADC is a Professional Counselor in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2017
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

622 Griggs St SE
Grand Rapids, MI 49507-2644
Phone: (616) 901-1650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401009405 (MI)

Record details

NPI number1689190290
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , LPC , CAADC
Sole proprietorYes
NPI enumeratedAugust 15, 2017
Last updated in NPPESJuly 21, 2022

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