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

Last updated

Oct 17, 2008By the provider in NPPES

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

Credentials

Master of Science

State licenses

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.

• Lewis & Clark Inc

  dba Speech Connection

  • Speech-Language Pathologist
  • Raleigh, NC
  • NPI 1609934082
  Authorized official Same address or phone

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": [],
    "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.