Active NPI
Stephanie Clark
- Counselor
- Silverdale, WA
National Provider Identifier
1447590575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60339793
- Practice address
- 3500 NW Bucklin Hill Rd
Suite 101
Silverdale, WA 98383-8503 - Phone
- (360) 337-2222
- NPI assigned
- Feb 27, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60339793 | WA | Primary |
Addresses
Primary practice location
3500 NW Bucklin Hill Rd
Suite 101
Silverdale, WA 98383-8503
Mailing address
3500 NW Bucklin Hill Rd
Suite 101
Silverdale, WA 98383-8503
Phone (360) 337-2222
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 |
|---|---|---|---|
| CG60339793 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olympic Peninsula Autism Center | Past | Accepting new patients | |
| Easter Seals Washington | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Olympic Peninsula Autism Center (OPAC)
- Community/Behavioral Health Agency
- Silverdale, WA
- NPI 1255682902
-
- Developmental Disabilities Clinic/Center
- Silverdale, WA
- NPI 1407113236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1447590575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 NW BUCKLIN HILL RD",
"address_2": "SUITE 101",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838503",
"telephone_number": "360-337-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 NW BUCKLIN HILL RD",
"address_2": "SUITE 101",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838503",
"telephone_number": "360-337-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-27",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60339793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.