C Clark LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

C CLARK LLC

Practice address

210 25TH Ave North
Suite 601, Room 13
Nashville, TN 37203

Phone

(615) 337-8709

NPI assigned

Oct 24, 2022

Organization subpart

No

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

Authorized official

Name

Chanella Latre Clark, LPCCNPI 1548823826

Title

Owner

Phone

(615) 337-8709

Specialties & licenses 1

Addresses

Other names 1

• Brain Domain, LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chanella Latre Clark, LPCC

  • Professional Counselor
  • Nashville, TN
  • NPI 1548823826

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1316664006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 5TH AVE N APT 204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372082798",
            "telephone_number": "615-337-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 25TH AVE NORTH",
            "address_2": "SUITE 601, ROOM 13",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-337-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C CLARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHANELLA",
        "authorized_official_middle_name": "LATRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-337-8709",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brain Domain, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Frances Byrnes, LCSW, LPC-MHSP
• Byron E. White ENT.
• Heidi Byron, DO
• Matthew Steven Byron, DPT
• Erica Byrum, ANP-BC
• C Philipp Mobility Equip.
• C Philipp Mobility Free Equip
• Lori Cabbage, CNM
• Calvin Cable, MD
• Jackson Joseph Sanden Cabo, MD

• Mental Health Counselor in Nashville, TN
• Providers in Nashville, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.