IndividualActive
Amanda Clark
NPI 1639965353 · Addiction (Substance Use Disorder) Counselor · Green Bay, WI
Provider details
- NPI number
- 1639965353
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 19549 (WI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2357 W Mason St
Green Bay, WI 54303-4708
Phone: (920) 337-6740
Approximate (ZIP-level) locationGet directions
Mailing address
2357 W Mason St
Green Bay, WI 54303-4708
Registry dates
- Enumerated
- 2025-04-18
- Last updated
- 2025-04-18
- Certified
- 2025-04-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.