Ruben Ray Clark, A.P.S.S
Individual provider Active NPI Peer Specialist · Jamestown, KY
NPI 1265242598 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1265242598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 119 Herrifords Cir
Jamestown, KY 42629-2520 - Phone
- (270) 343-2551
- NPI assigned
- Jan 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Cumberland Regional Mental Health Mental Retardation Board, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | KY | Yes |
Addresses
Primary practice location
119 Herrifords Cir
Jamestown, KY 42629-2520
Mailing address
119 Herrifords Cir
Jamestown, KY 42629-2520
Phone (270) 343-2551
Other providers in Jamestown, KY
- Kristy Lynn Campbell
- Michelle Egnew Carnes
- Reva Poynter Carnes
- Marci Chapman
- Bridget Clark
- Sarah Coe
- Laura Brooke Coffey
- Elaine Collins
- Jennifer Cooksey
- Cornerstone Diagnostics Inc
All providers in Jamestown, KY · Peer Specialist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.