Sheryl Anne Clark, LPC-A, LCAS-A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A12269 Issued in NC

Practice address

12740 Spruce Tree Way Ste 102
Raleigh, NC 27614-8295

Phone

(919) 916-1160

NPI assigned

Feb 23, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Carolina Counseling and Therapeutic Solutions

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1841896131
  NPD Authorized official

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1154822328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 SPRUCE TREE WAY STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148295",
            "telephone_number": "919-916-1160",
            "fax_number": "919-488-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 SPRUCE TREE WAY STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148295",
            "telephone_number": "919-916-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHERYL",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LPC-A, LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "A21708",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Porter Grace Clark, PA-C
• Rebecca Clark, LCMHCA
• Sandra Hewitt Clark, M.D.
• Shannon Joan Clark, AGNP RN
• Sharon Clark
• Trenita Clark, PHARMD
• Amie Lyons Clarke, P.A.-C
• Danilton Glenn Clarke, PT, DPT, CSCS
• Dannielle Clarke
• Decarna Clarke, PHARMD

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, 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 Feb 23, 2018; 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.