Phillip C Clarke, MS, EDS, NCC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5515 Issued in NC

Practice address

1 Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(336) 509-8915

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

No

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 Science

State licenses

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1184788697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 COTSWOLD TER",
            "address_2": "UNIT #3-C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108979",
            "telephone_number": "336-509-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-509-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "PHILLIP",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MS, EDS, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yetta Hardy Clark, CRNA
• Destiny Raven Clarke
• Hannah Grace Clarke, RD, LDN, PA-C
• Ladonna G Clarke
• Nadicca Clarke, BSN, RN
• Susan Clarke, MB BCH, MSC
• Faith Clary, OT
• Meredith Marie Clary, M.D.
• Adrienne Charles Classen, M.D.
• Tara Judith Claudio-Rivera

• Mental Health Counselor in Winston Salem, NC
• Providers in Winston Salem, 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 Sep 15, 2011; 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.