Active NPI
Eva Clark
- Professional Counselor
- Austin, TX
National Provider Identifier
1730639360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 82996
- Practice address
- 100 Congress Ave
Suite 2000
Austin, TX 78701-4072 - Phone
- (888) 880-9270
- NPI assigned
- Oct 6, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 82996 | TX | |
| Behavior Technician | 106S00000X | |||
| Professional Counselor | 101YP2500X | 82996 | TX | Primary |
Addresses
Primary practice location
100 Congress Ave
Suite 2000
Austin, TX 78701-4072
Mailing address
500 Fairway Dr
Suite 102
Deerfield Beach, FL 33441-1814
Phone (888) 880-9270
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 |
|---|---|---|---|
| 82996 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669161600000",
"number": "1730639360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 FAIRWAY DR",
"address_2": "SUITE 102",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334411814",
"telephone_number": "888-880-9270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CONGRESS AVE",
"address_2": "SUITE 2000",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787014072",
"telephone_number": "888-880-9270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "EVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-06",
"last_updated": "2022-11-23",
"certification_date": "2022-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "82996",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "82996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.