Amber Clark, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

140756 Issued in KY

Practice address

60 W Calvary Dr
Lebanon, KY 40033-8421

Phone

(270) 779-4143

NPI assigned

May 23, 2012

Last updated

Jun 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

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

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1710247846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W CALVARY DR",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400338421",
            "telephone_number": "270-779-4143",
            "fax_number": "859-336-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W CALVARY DR",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400338421",
            "telephone_number": "270-779-4143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Laura Sue Humphress Dr",
            "address_purpose": "LOCATION",
            "city": "Campbellsville",
            "state": "KY",
            "postal_code": "427188899",
            "country_code": "US",
            "telephone_number": "270-465-7768",
            "fax_number": "270-465-0068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AMBER",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "12-001",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "140756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Delanna Leigh Clark, APRN
• Heather Lacey Clark, DPT
• Clarkson Optometry Midwest Inc (20/20 EyeCare)
• Ruby Combs, RN
• Communicare Inc

• Speech-Language Pathologist in Lebanon, KY
• Providers in Lebanon, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.