DR. WILLIAM DAVE CLARK (NPI# 1023274503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023274503 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM DAVE CLARK |
| Credential | PH.D. |
| Practice Address |
1421 Ossahatchie Creek Rd Ellerslie GA 31807-5339 |
| Practice Telephone | 5613190625 |
| Mailing Telephone | 5613190625 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2008-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC001112 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447819677 | William Eugene Clark | Nurse's Aide | 2869 Howey Rd, Columbus, OH 43224-4028 | 2019-06-11 |
| 1528454154 | William Clark | Specialist/Technologist | 8501 Silverbrook Rd, Lorton, VA 22079-3015 | 2015-04-10 |
| 1639575830 | William Clark | Specialist/Technologist | 7 Reef Rd, Anderson, GU 83901 | 2014-11-15 |
| 1730423278 | William Douglas Clark | Mechanotherapist | 1617 Highway 20 W, Mcdonough, GA 30253-7311 | 2012-11-21 |
| 1487950606 | William D Clark | Massage Therapist | 1160 Lucerne Loop Rd Ne, Winter Haven, FL 33881-9681 | 2011-02-04 |
| 1124320692 | William Warren Clark | Recreation Therapist | 2118 Stagecoach Trl, Temple, TX 76502-3224 | 2010-12-03 |
| 1407093875 | William Todd Clark | Specialist/Technologist, Other | 305 Greenbriar Ct, Otisco, IN 47163-9601 | 2009-01-07 |
| 1922244524 | William J Clark | Technician/Technologist | 3984 Drexel Rd, Pittsburgh, PA 15212-1512 | 2009-01-02 |
| 1598938219 | William Little Clark | Orthopaedic Surgery | 5 Retreat Rd, Augusta, GA 30909-1837 | 2008-04-03 |
| 1245415116 | William J Clark | Pharmacist | 5335 W Genesee St, Suite 20, Camillus, NY 13031-2265 | 2008-01-09 |
| Street Address |
1421 OSSAHATCHIE CREEK RD |
| City | ELLERSLIE |
| State | GA |
| Zip Code | 31807-5339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568559185 | Jeffery A Kitchens | Physician Assistant | 1466 Ossahatchie Creek Rd, Ellerslie, GA 31807-5338 | 2006-10-06 |
| 1184237778 | Angelica Margarita Gonzalez Echevarria | Social Worker | 475 Marglo Cir, Ellerslie, GA 31807-5538 | 2020-08-25 |
| 1447715990 | Ariauna C. Washington | Specialist/Technologist | 71 Katherine Ct, Ellerslie, GA 31807-5867 | 2019-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237778 | Angelica Margarita Gonzalez Echevarria | Social Worker | 475 Marglo Cir, Ellerslie, GA 31807-5538 | 2020-08-25 |
| 1447715990 | Ariauna C. Washington | Specialist/Technologist | 71 Katherine Ct, Ellerslie, GA 31807-5867 | 2019-02-08 |
| 1639665102 | Mary Kathy Kasekamp | Private Vehicle | 10113 Hopkins St, Ellerslie, MD 21529-1102 | 2018-07-07 |
| 1568559185 | Jeffery A Kitchens | Physician Assistant | 1466 Ossahatchie Creek Rd, Ellerslie, GA 31807-5338 | 2006-10-06 |
| 1013935485 | Edward S Williams | Emergency Medical Technician, Paramedic | 14200 Ellerslie Road, Ellerslie, MD 21529-0237 | 2006-07-17 |
| 1811926405 | Ellerslie Volunteer Ambulance Service Inc | Ambulance | 14200 Ellerslie Rd, Ellerslie, MD 21529-1128 | 2006-07-03 |
| 1710473285 | Marlon Leo Kasekamp | Private Vehicle | 10113 Hopkins St, Ellerslie, MD 21529-1102 | 2018-07-07 |
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780859 | Jennifer Lynn Fedderick | Counselor | 459 Thrasher Rd, Plains, GA 31780-5310 | 2020-11-04 |
| 1376144766 | Arlicia Lagene Johnson | Counselor | 220 Osmanthus Way, Canton, GA 30114-7197 | 2020-11-03 |
| 1558962027 | Evan Kauper | Counselor | 2002 Smith Dr Nw, Kennesaw, GA 30144-1851 | 2020-11-02 |
| 1801496864 | Poonam A Patel | Counselor | 2916 Clairmont Rd Ne Apt 2413, Brookhaven, GA 30329-4476 | 2020-10-29 |
| 1740880061 | Pledger Behavior Consulting, LLC | Counselor | 7563 Highway 337, Summerville, GA 30747-6101 | 2020-10-27 |
| 1801495411 | Bianca Tiara Abrams | Counselor | 916 Glenwood Park Dr Se, Atlanta, GA 30316-6845 | 2020-10-23 |
| 1780283713 | Stacey Dougan | Counselor | 696 Mountain Dr Ne, Atlanta, GA 30342-3904 | 2020-10-21 |
| 1619576865 | Therapy Pond, LLC | Counselor | 1262 Concord Rd Se Ste 200, Smyrna, GA 30080-5307 | 2020-10-20 |
| 1164021259 | Miracles Outreach International | Counselor | 6825 Jimmy Carter Blvd Ste 1570b, Norcross, GA 30071-1215 | 2020-10-20 |
| 1699374025 | Alexxis Trimmings | Counselor | 205 W Montgomery Xrd Apt 106, Savannah, GA 31406-7121 | 2020-10-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.