Sally Clark Gex

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

200 Park Circle Dr
Suite 1
Flowood, MS 39232-7628

Phone

(601) 664-0455

NPI assigned

Feb 2, 2017

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

Other names 1

• Sarah Clark Gex Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 20, 2024 through Jun 20, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1720526403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARK CIRCLE DR",
            "address_2": "SUITE 1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARK CIRCLE DR",
            "address_2": "SUITE 1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327628",
            "telephone_number": "601-664-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEX",
        "first_name": "SALLY",
        "middle_name": "CLARK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "GEX",
            "middle_name": "CLARK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Counselor in Flowood, MS
• Providers in Flowood, MS by specialty
• Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.