James Richard Clark, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1913 Issued in OR

Practice address

534 NE Brookstone Dr
Prineville, OR 97754-3221

Phone

(541) 678-3342

NPI assigned

Nov 28, 2009

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 28, 2009.

{
    "created_epoch": "1259366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259366400000",
    "number": "1063740280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1211",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977540675",
            "telephone_number": "541-678-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 NE BROOKSTONE DR",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977543221",
            "telephone_number": "541-678-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-28",
        "last_updated": "2009-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Christensen, LMT
• Sarah Christians, COTA/L
• Christiansen, LLC
• Mindy Lynn Christiansen
• Anne Clark, BA, CADC I
• Karianne Clark
• Shelia Clark
• Delpha Coffman III, THW, CADC-R, QMHP-R
• Jennifer Lee Coffman, RN
• Alyssa Joann Colby, IBCLC, CHW

• All providers in Prineville, OR
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.