Andre Moshea Clark, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

125985 Issued in CA

Practice address

15720 Ventura Blvd
Encino, CA 91436-2914

Phone

(818) 927-0478

NPI assigned

Oct 5, 2022

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

Electronic endpoints 1

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": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1235854043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8668 SHANNONBROOK CT",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452668",
            "telephone_number": "850-241-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362914",
            "telephone_number": "818-927-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANDRE",
        "middle_name": "MOSHEA",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "125985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.findyourbalancecenter.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Correspondence",
            "address_1": "8668 Shannonbrook Ct",
            "city": "Lemon Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919452668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Chun, MD
• Angela Chung, MS, OTR/L, CHT
• Mei Chun Chung
• Cathy C Citron-Bilovsky, PH.D.
• Lauren Sara Civello, L.AC.
• Brooke Clark
• Kionna Clarkson
• Claudia Eskenazi,PH.D.,M.F.T.,a.T.R.,Family Therapist, P.C.
• Amy Levine Clayton, LCSW, PSY.D.
• Clear Choice Hearing Clinic Incorporated

• Mental Health Counselor in Encino, CA
• Providers in Encino, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.