Georgione Clarke

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

18-66401 Issued in TX

Practice address

1711 E Central Texas Expy Ste 304
Killeen, TX 76541-9147

Phone

(254) 265-6200

NPI assigned

Sep 10, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tri-City Autism Center, LLC

  • Behavior Analyst
  • Killeen, TX
  • NPI 1639730294
  NPD (past)

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1689223778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 E CENTRAL TEXAS EXPY STE 304",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765419147",
            "telephone_number": "254-265-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 E CENTRAL TEXAS EXPY STE 304",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765419147",
            "telephone_number": "254-265-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "GEORGIONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "18-66401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maliyah Clark
• Mary Suann Clark
• Michaela Breanne Clark
• Robert Damian Clark, PH.D.
• Yvonne Clark, NP
• Kelsey Clarke
• Lakeisha Lashon Marie Clay
• Elisa Claycomb
• Clear Creek Inpatient Physicians
• Clear Creek Pharmacy Inc

• Behavior Technician in Killeen, TX
• Providers in Killeen, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.