Active NPI
Aubrey Clark
- Professional Counselor
- Phoenix, AZ
National Provider Identifier
1679259790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 21458
- Practice address
- 7320 N Dreamy Draw Dr Ste 140
Phoenix, AZ 85020-0002 - Phone
- (623) 377-4248
- NPI assigned
- Jun 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 21458 | AZ | Primary |
Addresses
Primary practice location
7320 N Dreamy Draw Dr Ste 140
Phoenix, AZ 85020-0002
Mailing address
6409 W Wahalla LN
Glendale, AZ 85308-7085
Phone (765) 490-5788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21458 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742601600000",
"number": "1679259790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6409 W WAHALLA LN",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853087085",
"telephone_number": "765-490-5788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7320 N DREAMY DRAW DR STE 140",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850200002",
"telephone_number": "623-377-4248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "AUBREY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-23",
"last_updated": "2025-03-22",
"certification_date": "2025-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "21458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.