Sheldon Dunham Clark, LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6655 Issued in TN

Practice address

5120 Virginia Way Ste C-12
Brentwood, TN 37027-7515

Phone

(615) 212-8614

NPI assigned

Jun 26, 2024

Sex

Male

Sole proprietor

Yes

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

Opted out of Medicare

Yes, effective Oct 1, 2025 through Oct 1, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1356186803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 VIRGINIA WAY STE C-12",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277515",
            "telephone_number": "615-212-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 VIRGINIA WAY STE C-12",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277515",
            "telephone_number": "615-212-8614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Murfreesboro Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370675088",
            "country_code": "US",
            "telephone_number": "615-212-8614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHELDON",
        "middle_name": "DUNHAM",
        "name_prefix": "Mr.",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "6655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie F Clark
• Riley Clark, MS, CCC-SLP
• Robert Cornelius Clark III, PHARMD
• Sara Ansley Clark
• Shannon M Clark
• Ermose Claude
• Hailey Lynn Claye
• Devin Ane' Clayton-Jones, LMSW, CCM
• George H Clayton, D.D.S., F.A.C.P.
• Kenyatta Cleark, RPH, PHARMD

• Mental Health Counselor in Brentwood, TN
• Providers in Brentwood, 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 Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.