Kevin Clark
Individual provider Active NPI Mental Health Counselor · Swansea, MA
NPI 1487913232 · NPPES record last updated May 15, 2012
Key facts
- NPI
- 1487913232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 463 Swansea Mall Dr
Swansea, MA 02777-4119 - Phone
- (508) 324-1060
- NPI assigned
- May 15, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
463 Swansea Mall Dr
Swansea, MA 02777-4119
Mailing address
463 Swansea Mall Dr
Swansea, MA 02777-4119
Other providers in Swansea, MA
- CH-Country Gardens LLC
- Elizabeth Lee Chafee
- Anita Chamoun
- Cheryl Ann Chernecky
- Claire V Wiseman LLC
- Christopher Michael Cocozella
- Leigh Ann Coderre
- Kristen Williams Coffey
- Sarah Cohen
- Colbert Counseling LLC
All providers in Swansea, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.