Ginna Clark, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0140471 Issued in NM

Practice address

1344 Pacheco St
Suite a
Santa Fe, NM 87505-4267

Phone

(505) 316-0775

Fax

(972) 736-2271

NPI assigned

Sep 29, 2009

Last updated

Sep 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1427382043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 PACHECO ST",
            "address_2": "SUITE A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054267",
            "telephone_number": "505-316-0775",
            "fax_number": "972-736-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 PACHECO ST",
            "address_2": "SUITE A",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054267",
            "telephone_number": "505-316-0775",
            "fax_number": "972-736-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GINNA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0140471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Todd Clancy, M.D.
• Clarice K. Pick, D.D.S., P.C.
• Abra Clark-Van Brunt
• Christopher A Clark
• Evelyn Frances Clark, L.M.T.
• Sarha Lillian Clark, LMSW
• Corey D Clay, MD, PHD
• Michael Barnett Clayman, DDS
• Benjamin Thomas Clayton del Toro, PHARM.D., PH.D.
• Clear Vision Inc.

• Professional Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.