Demetrice Clark

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

8946 Interline Ave Ste a
Baton Rouge, LA 70809-1913

Phone

(225) 253-1277

NPI assigned

Oct 29, 2015

Last updated

Oct 29, 2015By the provider in NPPES

Sex

Female

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

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Array of Hope Outreach Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baton Rouge, LA
  • NPI 1194173005
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1528430550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8946 INTERLINE AVE STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091913",
            "telephone_number": "225-253-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8946 INTERLINE AVE STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091913",
            "telephone_number": "225-253-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DEMETRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Howland Clark, P.A.
• Anthony Martin Clark II
• Ashley Clark, APRN, NP-C, PMHNP-BC
• Bryant Clark
• Dammeion Nyoka Lashe Clark
• Demetrius Clark
• Donald Clark
• Donyelle Clark, M.S., BCBA
• Erika Clark, NREMT
• Evelyn Elizabeth Clark

• Mental Health Counselor in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.