Robert Lee Clark, MS

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LH00007258 Issued in WA

Practice address

905 NE 68TH St
Ste 2
Vancouver, WA 98665-0585

Phone

(360) 991-8759

Fax

(360) 574-2806

NPI assigned

Jun 2, 2011

Sex

Male

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

• Bobby Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1093009458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 NE 68TH ST",
            "address_2": "STE 2",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650585",
            "telephone_number": "360-991-8759",
            "fax_number": "360-574-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 NE 68TH ST",
            "address_2": "STE 2",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650585",
            "telephone_number": "360-991-8759",
            "fax_number": "360-574-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH00007258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBY",
            "last_name": "CLARK",
            "credential": "MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laurel Megan Clark, LMT
• Mark W Clark, PSY.D.
• Misty Noel Clark, RN
• Nicolas Clark, CBT70128252
• Richard Clark
• Shelley Lynn Clark, LICSW
• Steven Clark, O.D.
• Taylor Rey Clark, LMHC, NCC
• Alison Lee Clarke, DO
• Morgan Miquela Warren Clarkson, MD

• Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.