Skyler Clark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC013107 Issued in GA

Practice address

27 S Main St
Statesboro, GA 30458-5245

Phone

(912) 225-3769

NPI assigned

Aug 23, 2022

Sex

Female

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.

• Brave Tomorrow Counseling and Consulting

  • Community/Behavioral Health Agency
  • Statesboro, GA
  • NPI 1104287333
  NPD
• Brave Tomorrow Counseling and Consulting

  • Community/Behavioral Health Agency
  • Pooler, GA
  • NPI 1487437729
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 23, 2022.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1104545342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1242",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304591242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S MAIN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585245",
            "telephone_number": "912-225-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SKYLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Wyatt Clark, PHARM.D
• Gayle Chappell Clark, R.PH
• Iris Kalin Clark, M.D.
• Michael Ryan Clark, PHARMD
• Shantera Clark, FNP-C
• Taylor Victoria Clark
• Shelly Clary, FNP-BC
• Heather Cleary, LPC
• Clemons Family Practice, Inc.
• Amy Dawn Clemons, M.D.

• All providers in Statesboro, GA
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.