Deborah A Clark, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4166 Issued in SC

Practice address

1500 Lady St
Columbia, SC 29201-3402

Phone

(803) 779-1995

Fax

(803) 779-7881

NPI assigned

Sep 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376648857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LADY ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013402",
            "telephone_number": "803-779-1995",
            "fax_number": "803-779-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LADY ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013402",
            "telephone_number": "803-779-1995",
            "fax_number": "803-779-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "4166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda K Clark, RRT
• Amanda S Clark, FNP
• Antoinette Clark
• Daryl Clark
• Dawn M. Clark, CRNA
• Demetria Godfrey Clark
• Derek Clark, DPT
• Elijah Clark
• Elizabeth Clark, RN, BSN
• Eric Clark

• Mental Health Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.