Benjamin A Clark

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

8512 Issued in SD

Practice address

1028 Walnut St
Yankton, SD 57078-2910

Phone

(605) 665-4606

NPI assigned

Sep 27, 2021

Sex

Male

Sole proprietor

No

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.

• Lewis & Clark Behavioral Health Services, Inc.

  • Community/Behavioral Health Agency
  • Yankton, SD
  • NPI 1215918339
  NPD (past)
• Lewis & Clark Mental Health Center

  • Mental Health Counselor
  • Yankton, SD
  • NPI 1972862969
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1083385124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W 30TH ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 WALNUT ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570782910",
            "telephone_number": "605-665-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BENJAMIN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SD",
            "license": "8512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tallie Cassanova
• Kellie Castillo
• Cedar Vilage Assisted Living Center
• Cynthia Chavez
• Brenden Thomas Christensen
• Claire Clifton
• William Edward Cohen, MD
• Shawn Coles
• Kourtney Lou Colpitts
• Confidently You LLC

• All providers in Yankton, SD
• Addiction (Substance Use Disorder) Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.