GWENDOLYN D CLARK (NPI# 1588620538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588620538 |
| Entity Type | Individual |
| Full Name | GWENDOLYN D CLARK |
| Credential | LCSW |
| Practice Address |
218 Holiday Hills Dr Wilmington NC 28409-3514 |
| Practice Telephone | 9106120782 |
| Mailing Telephone | 9106120782 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2010-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
C002055 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | LICENSE | C002055 | 01 |
| NC | BCBS # | 1312U | 01 |
| NC | 6106158 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497988141 | Gwendolyn Marie Clark | Counselor | 2651 S High St, Denver, CO 80210-5936 | 2009-08-28 |
| Street Address |
218 HOLIDAY HILLS DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28409-3514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952916728 | Emily Savannah Holland | Specialist/Technologist | 1150 King's Hwy, Wilmington, NC 28409 | 2020-09-09 |
| 1912373465 | Thomas Malenfant | Hearing Instrument Specialist | 474 New Centre Drive, #6, Wilmington, NC 28409 | 2015-08-19 |
| 1720482862 | Leslie Morton Garris | Pharmacist | 6013 Chancellorville Drive, Wilmington, NC 28409 | 2014-10-17 |
| 1659621720 | Charles Warren Moorehead | Social Worker | 5710 Oleander Dr. Suite 208, Wilmington, NC 28409 | 2012-09-14 |
| 1992972020 | Nancy Beth Kotz | Social Worker | 6211 Terrapin Ct, Wilmington, NC 28409 | 2008-05-08 |
| 1366611089 | Michael Royce Penland | Psychologist | 5002-1 Hewletts Run, Wilmington, NC 28409 | 2008-02-27 |
| 1184755092 | Keith W Mann | Dentist | 818-101 Pine Grove Drive, Wilmington, NC 28409 | 2007-03-09 |
| 1477650554 | Jeffrey Beecham Chick | Specialist | 1201 Porches Dr, Suite 2, Wilmington, NC 28409 | 2006-09-20 |
| 1407964067 | Richard A. Lally | Counselor | 5425 Golden Eagle Court, Wilmington, NC 28409 | 2006-08-25 |
| 1598290520 | Monaca Lachman | Counselor | 6020 Leeward Ln, Wilmington, NC 28409-0129 | 2017-04-27 |
| Find all providers in zip 28409 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656172 | Jennifer Hickman Grimm | Counselor | 1014 Steeplechase Rd, Wilmington, NC 28412-7206 | 2020-10-14 |
| 1821696717 | Tessa Jane Bolz | Counselor | 2426 Monroe St, Wilmington, NC 28401-7026 | 2020-10-13 |
| 1588278600 | Kimberly Jackson | Counselor | 2703 N Harrison St, Wilmington, DE 19802-2924 | 2020-09-04 |
| 1134746399 | Heather Nicole Freeman | Counselor | 771 Bonaire Rd, Wilmington, NC 28412-3282 | 2020-07-02 |
| 1497393441 | Julie Elaine Campana | Counselor | 501 Silverside Rd Ste 50, Wilmington, DE 19809-1388 | 2019-12-19 |
| 1205473360 | Keonna M Freeman | Counselor | 5700 Kirkwood Hwy Ste 204, Wilmington, DE 19808-4884 | 2019-12-06 |
| 1699311381 | Rebecca L Dries | Counselor | 1201 W 7th St Apt 3, Wilmington, DE 19805-3258 | 2019-11-18 |
| 1811532286 | Carolyn Elizabeth Lehman | Counselor | 815 N Harrison St, Wilmington, DE 19806-4628 | 2019-11-09 |
| 1639713183 | Richard Luke Loveless Jr. | Counselor | 3719 Washington Ave, Wilmington, DE 19808-6034 | 2019-10-28 |
| 1396388153 | Jennifer Cook | Counselor | 5710 Oleander Dr Ste 112, Wilmington, NC 28403-4722 | 2019-10-24 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28409 |
Please comment or provide details below to improve the information on GWENDOLYN D 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.