Sean Clark, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MT.0016060 Issued in CO

Practice address

151 S College Ave
Suite A4
Fort Collins, CO 80524-2864

Phone

(970) 305-2197

Fax

(855) 300-9423

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1497979298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S COLLEGE AVE",
            "address_2": "SUITE A4",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242864",
            "telephone_number": "970-305-2197",
            "fax_number": "855-300-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S COLLEGE AVE",
            "address_2": "SUITE A4",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242864",
            "telephone_number": "970-305-2197",
            "fax_number": "855-300-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "MT.0016060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joann Clark, PT
• Marcy Clark, L.C.S.W.
• Michelle Clark, LPC, CAC II
• Neelofer Baig Clark, L AC RN, FNP-C
• Rozella Rebecca Clark
• Warren James Clark, DDS
• Wendy Clark
• Emily Paige Clarkson, RDH
• Cheyenne Clayson, PA-C
• Clear Creek Dental

• Specialist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.