Herman Clark, LCAS-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6614 Fawn View Drive
Charlotte, NC 28216

Phone

(704) 564-8981

NPI assigned

Dec 28, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1144550005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 FAWN VIEW DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164847",
            "telephone_number": "704-564-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 FAWN VIEW DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28216",
            "telephone_number": "704-564-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HERMAN",
        "name_prefix": "Mr.",
        "credential": "LCAS-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-28",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3196-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demeatris Clark, M.A, LCAS-A
• Donald Eugene Clark
• Elizabeth Anne Clark, MD, MPH
• Elizabeth Anne Clark, LCSW
• Emily A Clark, SLP
• Jason Drew Clark, D.D.S.
• John B Clark Jr., M.D.
• Kortney Wilson Clark, FNP
• Kristie Dawn Clark, PHARMD, CDE
• Laura L Clark, MS, LCAS

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.