Active NPI
Darian Clark
- Mental Health Counselor
- Hallandale Beach, FL
National Provider Identifier
1407639628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH22495
- Practice address
- 1300 Moffett St Apt 206
Hallandale Beach, FL 33009-2746 - Phone
- (201) 264-0420
- NPI assigned
- Aug 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH22495 | FL | Primary |
Addresses
Primary practice location
1300 Moffett St Apt 206
Hallandale Beach, FL 33009-2746
Mailing address
1300 Moffett St Apt 206
Hallandale Beach, FL 33009-2746
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH22495 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1407639628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 MOFFETT ST APT 206",
"city": "HALLANDALE BEACH",
"state": "FL",
"postal_code": "330092746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 MOFFETT ST APT 206",
"city": "HALLANDALE BEACH",
"state": "FL",
"postal_code": "330092746",
"telephone_number": "201-264-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DARIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-14",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH22495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hallandale Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.