MR. EDWARD G CLARK (NPI# 1578747432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578747432 |
| Entity Type | Individual |
| Full Name | MR. EDWARD G CLARK |
| Practice Address |
804 Stamper Rd Suite 101 Fayetteville NC 28303-4379 |
| Practice Telephone | 9103232875 |
| Mailing Telephone | 9103232875 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6688 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043570732 | Edward Clark | Counselor | 4015 Nine Mcfarland Dr, Suite #175, Alpharetta, GA 30004-8493 | 2012-05-29 |
| 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 |
| Street Address |
804 STAMPER RD SUITE 101 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-4379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285703488 | John D.a. Vaughn | Counselor | 804 Stamper Rd, Suite 101, Fayetteville, NC 28303-4379 | 2006-11-06 |
| 1922497379 | Monica Grambusch | Counselor | 804 Stamper Rd, Suite 101, Fayetteville, NC 28303-4379 | 2015-01-22 |
| 1073717880 | Home Health Alliance, Inc. | Home Health | 804 Stamper Rd, Suite 201, Fayetteville, NC 28303-4379 | 2007-06-14 |
| 1346369873 | Home Health Alliance, Inc. | Home Health | 804 Stamper Rd, 201, Fayetteville, NC 28303-4379 | 2007-03-28 |
| 1760518864 | Qualified Health Connections. Inc | Community/Behavioral Health | 804 Stamper Rd, Suite 201, Fayetteville, NC 28303-4379 | 2007-02-26 |
| 1124172499 | Raintree Clinic | Counselor | 804 Stamper Rd, Suite 101, Fayetteville, NC 28303-4379 | 2007-01-23 |
| 1629120696 | Edward Mcdonald Vaughn Jr. | Counselor | 804 Stamper Rd, Suite 101, Fayetteville, NC 28303-4379 | 2007-01-18 |
| 1750447694 | Maxine Mcguire | Counselor | 804 Stamper Rd, Suite 101, Fayetteville, NC 28303-4379 | 2006-12-28 |
| 1346305331 | Swany Blanco | Counselor | 804 Stamper Rd, Suite 101, Fayetteville, NC 28303-4379 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899986 | Cynthia Hrdlichka | Counselor | 2224 E Elaine Ave, Fayetteville, AR 72703-4507 | 2020-10-20 |
| 1568069169 | Blaire Bradbury | Counselor | 1466 N Desoto Pl, Fayetteville, AR 72703-1953 | 2020-10-06 |
| 1588294631 | Puzzle Collaborative | Counselor | 34 W Colt Square Dr Ste 1, Fayetteville, AR 72703-2888 | 2020-01-16 |
| 1700421724 | Waylon Vande Hoef | Counselor | 1925 N Green Acres Rd, Fayetteville, AR 72703-2617 | 2019-11-13 |
| 1730640137 | Sherrita Hedgepeth | Counselor | 1351 Glen Iris Dr Apt 105, Fayetteville, NC 28314-6190 | 2019-03-28 |
| 1689139362 | Resiliency Behavioral Health Services LLC | Counselor | 145 Govenors Square, Ste A, Fayetteville, GA 30269 | 2019-02-06 |
| 1073006540 | Rona Gooden | Counselor | 706 Dandridge Dr, Fayetteville, NC 28303-2017 | 2018-06-10 |
| 1194229245 | The Welling Place LLC | Counselor | 2525 Raeford Rd Ste C, Fayetteville, NC 28305-5092 | 2018-03-22 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1376062539 | Monique R Darnell | Counselor | 320 W. Lanier Avenue Ste 200, Fayetteville, GA 30214 | 2017-09-19 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on MR. EDWARD G 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.