Active NPI
Doris Clark, M.ED, ED.S, NCC, LPC
- Professional Counselor
- Greenville, SC
National Provider Identifier
1457082422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9910
- Practice address
- 23 Buena Vista Way Ste B
Greenville, SC 29615-5092 - Phone
- (864) 485-9195
- NPI assigned
- Jun 21, 2022
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 9910 | SC | Primary |
Addresses
Primary practice location
23 Buena Vista Way Ste B
Greenville, SC 29615-5092
Mailing address
23 Buena Vista Way Ste B
Greenville, SC 29615-5092
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9910 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1457082422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 BUENA VISTA WAY STE B",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296155092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 BUENA VISTA WAY STE B",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296155092",
"telephone_number": "864-485-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DORIS",
"credential": "M.ED, ED.S, NCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-21",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "9910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.