Leah Nicole Clark, MED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

KY-0773 Issued in KY

Practice address

714 Lyndon LN
Suite 1
Louisville, KY 40222-4643

Phone

(502) 426-2777

Fax

(502) 426-2776

NPI assigned

Nov 26, 2012

Last updated

Nov 26, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1154665438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 LYNDON LN",
            "address_2": "SUITE 1",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224643",
            "telephone_number": "502-426-2777",
            "fax_number": "502-426-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 LYNDON LN",
            "address_2": "SUITE 1",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224643",
            "telephone_number": "502-426-2777",
            "fax_number": "502-426-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LEAH",
        "middle_name": "NICOLE",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "KY-0773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Clark
• Kylie Clark, DPT
• Latoya Shaneese Clark, PHARMD
• Laura DL Clark, MD
• Leah Clark, RBT
• Maci Danielle Clark
• Mark E Clark, MS
• Mary Clemons Clark, DMD
• Megan B Clark
• Melanie Jo Clark, MSN, APRN

• Mental Health Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.