PHILLIP J CLARK (NPI# 1881838027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881838027 |
| Entity Type | Individual |
| Full Name | PHILLIP J CLARK |
| Practice Address |
206 Lilly Rd Ne Apt B5 Olympia WA 98506-5011 |
| Practice Telephone | 4256791362 |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912451 | Phillip Douglas Clark Sr. | Home Health Aide | 2126 Highway 9 E Unit 5b, Longs, SC 29568-5725 | 2020-11-03 |
| 1629471412 | Phillip Wayne Clark | Nurse Practitioner | 150 E. Tyson Rd, Quartzsite, AZ 85359-4618 | 2014-10-07 |
| 1083272934 | Phillip Clark | Physical Therapy Assistant | 4560 Se International Way Ste 100, Milwaukie, OR 97222-4628 | 2019-06-04 |
| 1568950764 | Phillip A Clark | Counselor | 925 Brockhurst St, Oakland, CA 94608-4222 | 2018-04-24 |
| 1669991691 | Phillip Clark | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2017-09-11 |
| 1194169144 | Phillip Don Clark | Radiology | 1924 Alcoa Hwy # U107, Knoxville, TN 37920-1511 | 2013-04-22 |
| Street Address |
206 LILLY RD NE APT B5 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558976308 | Ashley Ann Salas | Counselor | 6810 36th Ave Se, Olympia, WA 98503-3934 | 2020-09-09 |
| 1205465622 | Falina Marie Luce | Counselor | 3285 Ferguson St, Olympia, WA 98512 | 2020-04-07 |
| 1528608387 | Katharine Garvey | Counselor | 4410 Goldcrest Dr Nw, Olympia, WA 98502-9018 | 2020-01-09 |
| 1083253702 | Maryellen S Ward | Counselor | 4922 Puget Rd Ne, Olympia, WA 98516-9211 | 2019-12-27 |
| 1720552086 | James Stewart | Counselor | 1410 Dickinson Ave Nw, Olympia, WA 98502-4617 | 2019-01-18 |
| 1700359676 | Carolyn Stringer | Counselor | 1223 6th Ave Sw, Olympia, WA 98502-5419 | 2019-01-03 |
| 1598264756 | Erik Keith Gordon | Counselor | 611 Cushing St Sw, Olympia, WA 98502-5110 | 2018-02-02 |
| 1710499330 | Abrea Lynn Anderson | Counselor | 7032 Mirasett St Sw, Olympia, WA 98512-1814 | 2017-11-05 |
| 1316476039 | James Gibson | Counselor | 3775 Martin Way E # B, Olympia, WA 98506-5007 | 2017-06-06 |
| 1174970594 | Creative Solutions Counseling | Counselor | 2345 Carpenter Rd Ne, Olympia, WA 98516-3863 | 2016-05-16 |
| Find all providers in OLYMPIA | ||||
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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.