Valerie Clack, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-32225

Practice address

624 Ponder Place Dr
Evans, GA 30809-3343

Phone

(706) 863-9699

Fax

(904) 538-0714

NPI assigned

Sep 13, 2017

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paul Napier Behavioral Consultation Services-Augusta, LLC

  • Behavior Analyst
  • Martinez, GA
  • NPI 1427311620
  NPD (past)

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1518486232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566755",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 PONDER PLACE DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093343",
            "telephone_number": "706-863-9699",
            "fax_number": "904-538-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLACK",
        "first_name": "VALERIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-32225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradford Kesler Cheek, FNP
• Demario Childs
• Avis Francina China, LPC
• Christy Canady, LLC
• Christy H. Dunn, LLC
• Katelyn Elizabeth Hankinson Clamp, OTR/L
• Jerica Clark-Wilborn
• Arianna Elizabeth Clark
• Natalie Laura Clarke, MD
• Kelsey Ann Clegg, PA-C

• Behavior Analyst in Evans, GA
• Providers in Evans, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.