Cory Clark, M.ED, NCC, LPC-A

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A12434 Issued in NC

Practice address

1151 Executive Cir
Suite 102
Cary, NC 27511-4589

Phone

(919) 462-8308

Fax

(919) 462-0433

NPI assigned

Sep 17, 2016

Last updated

Sep 17, 2016By the provider in NPPES

Sex

Male

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 Education

State licenses

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

{
    "created_epoch": "1474070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474070400000",
    "number": "1659829752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 EXECUTIVE CIR",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114589",
            "telephone_number": "919-462-8308",
            "fax_number": "919-462-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 EXECUTIVE CIR",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114589",
            "telephone_number": "919-462-8308",
            "fax_number": "919-462-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CORY",
        "credential": "M.ED, NCC, LPC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-17",
        "last_updated": "2016-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A12434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Hickey Clare, D.D.S.
• Kristen Samuhel Clarey, MD
• Abigail Bright Clark
• Alexander Jay Clark, MD
• Christina Allison Clark, CCC-SLP
• Denny Clark
• Devante Montrez Clark
• Dominick Clark
• Ebonee Monique Clark, LCMHCA
• Kalaysha Clark

• Professional Counselor in Cary, NC
• Providers in Cary, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2016; 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.