Sandra Sue Clark, M.ED.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

450 Ouray Ave
Grand Junction, CO 81501-2536

Phone

(970) 241-6099

Fax

(970) 241-0797

NPI assigned

Apr 7, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Sandy Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Colorado West Regional Mental Health, Inc.

  • Professional Counselor
  • Grand Junction, CO
  • NPI 1275214959
  NPD (past)
• Colorado West Regional Mental Health, Inc.

  • Community/Behavioral Health Agency
  • Grand Junction, CO
  • NPI 1881251460
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1073931085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HORIZON DR STE 225",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 OURAY AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012536",
            "telephone_number": "970-241-6099",
            "fax_number": "970-241-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SANDRA",
        "middle_name": "SUE",
        "credential": "M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDY",
            "last_name": "CLARK",
            "credential": "M.ED.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Haley M Clark, PT, DPT
• Jillian Clark
• Larry Cromwell Clark, PHARM.D., M.S.
• Mary Kay Clark, LPC
• Riley Nicole Clark
• Shyliea Rain Clark
• Terry R Clark
• Leah Clearwater, LPC
• Felicia Clemmons
• Rachelle Marie Clennin

• Case Manager/Care Coordinator in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Case Manager/Care Coordinator in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.