Doreen Elizabeth Clark, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3792 Issued in NC

Practice address

6600 Six Forks Rd
Ste 202
Raleigh, NC 27615-6517

Phone

(919) 787-4400

Fax

(919) 510-0070

NPI assigned

Dec 5, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1598823957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 LYNCHESTER CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157301",
            "telephone_number": "919-846-3652",
            "fax_number": "919-510-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 SIX FORKS RD",
            "address_2": "STE 202",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156517",
            "telephone_number": "919-787-4400",
            "fax_number": "919-510-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DOREEN",
        "middle_name": "ELIZABETH",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411594",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Clark, MSW, LCSWA
• Casey Clark, ARNP
• Chalondra Clark
• Danielle Clark
• David A Clark, MD
• Erika L. Clark, MD
• Faith Marrissa Clark, RPH.
• George Thomas Clark III, MD
• Jill Page Clark, COTA/L
• Jon Clark

• Speech-Language Pathologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; 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.