James Earl Clark, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

7058 Issued in TX

Practice address

105 Kathryn Dr Ste D
Lewisville, TX 75067-4200

Phone

(800) 972-0643

Fax

(214) 279-5032

NPI assigned

Dec 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rayl Enterprises

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Worth, TX
  • NPI 1891044228

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1366101321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 FM 2181 STE 230-517",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "762104219",
            "telephone_number": "800-972-0643",
            "fax_number": "214-279-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 KATHRYN DR STE D",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750674200",
            "telephone_number": "800-972-0643",
            "fax_number": "214-279-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "EARL",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "7058",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "7058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7058",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@grace-counseling.com",
            "affiliation": "N",
            "endpointDescription": "info@grace-counseling.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 Kathryn Dr Ste D",
            "city": "Lewisville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750674200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Ciolino, PA-C
• City of Lewisville
• Clark C. Byroad D.C., P.a.
• Claire Clark
• Dallas Clark, DC
• Richard Clark, PSY.D.
• Taylor Clark
• Lisa K Clayton, M.D.
• Clear Eye & Optical Flower Mound PLLC
• Clear Vision Associates PLLC

• Addiction (Substance Use Disorder) Counselor in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.