FANCHON MARIE CLARK M.A., LPC, CAADC
NPI 1689190290
Counselor - Professional in Grand Rapids, MI

Q: What is Fanchon Clark's NPI number?

The NPI number for Fanchon Clark is 1689190290. It was assigned to this individual provider in the NPPES registry on August 15, 2017. The provider is also known as Fanchon Clark Harvey.

Q: What is Fanchon Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Fanchon Clark was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 15, 2017

622 GRIGGS ST SE, GRAND RAPIDS, MI 49507(616) 901-1650 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 15, 2017 (2 updates tracked since 2017).

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About Fanchon Marie Clark M.a., Lpc, Caadc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FANCHON MARIE CLARK M.A., LPC, CAADC (NPI 1689190290) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401009405) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1689190290

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameFANCHON MARIE CLARKCredential: M.A., LPC, CAADC

Location Address622 GRIGGS ST SEGrand Rapids, MI 49507-2644

Mailing Address622 Griggs St SeGrand Rapids, MI 49507-2644 · (616) 901-1650

Phone(616) 901-1650

Sole ProprietorYes

Enumeration DateAugust 15, 2017

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1689190290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MI · 6401009405

622 GRIGGS ST SE, Grand Rapids, MI 49507

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Other Names 1

Former Name (1)Fanchon Clark Harvey

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fanchon Clark's NPI number?

The NPI number for Fanchon Clark is 1689190290. It was assigned to this individual provider in the NPPES registry on August 15, 2017. The provider is also known as Fanchon Clark Harvey.

Where is Fanchon Clark located?

Fanchon Clark practices at 622 Griggs St SE, Grand Rapids, MI 49507. The listed phone number is (616) 901-1650.

What is Fanchon Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Fanchon Clark was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.