EDWARD CLARK (NPI# 1043570732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043570732 |
| Entity Type | Individual |
| Full Name | EDWARD CLARK |
| Credential | LPC., CCADC |
| Practice Address |
4015 Nine Mcfarland Dr Suite #175 Alpharetta GA 30004-8493 |
| Practice Telephone | 6789829039 |
| Practice Fax Number | 4702358705 |
| Mailing Telephone | 6789829039 |
| Mailing Fax Number | 4702358705 |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2014-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 102L00000X | Psychoanalyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093028870 | Edward Derby Clark I | Counselor | 1355 Pebblewood Dr, Sacramento, CA 95833-1612 | 2010-07-21 |
| 1053474080 | Edward Joseph Clark IIi | Radiology | 1705 S. Tarboro St, Wilson, NC 27893 | 2006-12-19 |
| 1730294232 | Edward Deallen Clark | Obstetrics & Gynecology | 1600 W College St Ste Ll10, Grapevine, TX 76051-3598 | 2006-08-21 |
| 1205843604 | Edward Mark Clark | Dentist | 5211 Yellowstone Rd, Ste # 1, Cheyenne, WY 82009-4761 | 2006-08-01 |
| 1528074523 | Edward Lee Clark | Dentist | 2727 Sw 17th Pl, Redmond, OR 97756-1297 | 2006-07-31 |
| 1124028311 | Edward C Clark | Ophthalmology | 11355 Pembrooke Sq, Suite 107, Waldorf, MD 20603-4805 | 2005-07-28 |
| 1013917814 | Edward C Clark | Internal Medicine | 311 W 24th St, Suite 402, Erie, PA 16502-2665 | 2005-07-22 |
| 1063072429 | Edward Clark | Technician | 1310 6th St Nw, Washington, DC 20001-3495 | 2019-06-18 |
| 1710490800 | Edward E Clark Jr. | Registered Nurse | 10 Penfield Ave, Akron, OH 44310-2912 | 2017-11-10 |
| 1033638424 | Edward Clark | Licensed Practical Nurse | 6600 E Ben White Blvd, Austin, TX 78741-7537 | 2017-09-17 |
| Street Address |
4015 NINE MCFARLAND DR SUITE #175 |
| City | ALPHARETTA |
| State | GA |
| Zip Code | 30004-8493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366065823 | Rena Wilson | Neuromusculoskeletal Medicine, Sports Medicine | 3442 Francis Road Suite 130, Alpharetta, UNITED STATES 30004 | 2020-05-19 |
| 1538665963 | Pinnacle Endodontics of Crabapple, LLC | Dentist | 12250 Crabapple Road, Alpharetta, GA 30004 | 2018-04-04 |
| 1508369372 | Michael William Freeman | Chiropractor | 12389 Crabapple Road, Alpharetta, GA 30004 | 2018-03-17 |
| 1457851040 | Dzeneta Krndzija | Nurse Practitioner | 2980 Serenade Ct., Milton, GA 30004 | 2018-02-20 |
| 1881109684 | B.spectacled | Optometrist | 50 Canton Street, Ste 112, Alpharetta, GA 30004 | 2017-12-04 |
| 1477094498 | Caroline Sassetti-hryczyk | Nurse Practitioner | 162 Taylor Ridge Way, Milton, GA 30004 | 2017-03-09 |
| 1043696735 | Caregiver Health Solutions, LLC | Home Health | 3505 Peacock Rd, Alpharetta, GA 30004 | 2015-08-04 |
| 1124418371 | Francella Bonilla | Physical Therapy Assistant | 4805 Waterbrooke Xing, Alpharetta, GA 30004 | 2015-01-27 |
| 1548672082 | Crabapple Smiles Dental Group PC | Dentist | 12460 Crabapple Road, Suite 801, Alpharetta, GA 30004 | 2014-06-02 |
| 1578988697 | Heartland Dental Care of Georgia, P.C. | Dentist | 12988 Georgia Highway 9, Milton, GA 30004 | 2014-02-26 |
| Find all providers in zip 30004 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061331 | Justin White | Counselor | 1025 Powers Pl, Alpharetta, GA 30009-8356 | 2020-10-22 |
| 1164029559 | Bridget Anne Spicer | Counselor | 8945 Powderdam Dr, Alpharetta, GA 30022-5453 | 2020-10-08 |
| 1700498979 | Outpatient Behavioral Health, LLC | Counselor | 5755 N Point Pkwy Ste 256, Alpharetta, GA 30022-1174 | 2020-08-19 |
| 1760007728 | Jessalyn Palmer | Counselor | 1010 Bay Pointe Xing, Alpharetta, GA 30005-6955 | 2020-06-15 |
| 1174168488 | Julie Conrad | Counselor | 12705 Century Dr Unit D, Alpharetta, GA 30009-8378 | 2019-11-11 |
| 1720634603 | Angela U. Seymour, LLC | Counselor | 11080 Old Roswell Rd Ste 203, Alpharetta, GA 30009-4759 | 2019-08-15 |
| 1528620051 | Bright Path Therapy and Wellness Center | Counselor | 1071 Cambridge Sq Ste A, Alpharetta, GA 30009-1843 | 2019-07-04 |
| 1124590112 | Natasha Dedijer-turner | Counselor | 3740 Oakland Chase, Alpharetta, GA 30004-5918 | 2019-01-02 |
| 1497230999 | Mark Jason Sherling | Counselor | 201 Vaughn Dr, Alpharetta, GA 30009-2333 | 2018-10-01 |
| 1023507126 | Rabia Osman Khan | Counselor | 1065 Winthrope Park Dr, Alpharetta, GA 30009-2385 | 2018-05-03 |
| Find all providers in ALPHARETTA | ||||
| City | ALPHARETTA |
| Zip Code | 30004 |
Please comment or provide details below to improve the information on EDWARD CLARK.
| 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.