Active NPI
Terry Clarke, LCDC
- Addiction (Substance Use Disorder) Counselor
- Austin, TX
National Provider Identifier
1740938844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15547
- Practice address
- 1110 W William Cannon Dr Ste 303
Austin, TX 78745-3188 - Phone
- (512) 899-2100
- Fax
- (512) 899-2205
- NPI assigned
- Mar 17, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15547 | TX | Primary |
Addresses
Primary practice location
1110 W William Cannon Dr Ste 303
Austin, TX 78745-3188
Mailing address
3300 Parker LN Apt 266
Austin, TX 78741-6972
Phone (325) 763-8994
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 |
|---|---|---|---|
| 15547 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1740938844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 PARKER LN APT 266",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787416972",
"telephone_number": "325-763-8994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 W WILLIAM CANNON DR STE 303",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787453188",
"telephone_number": "512-899-2100",
"fax_number": "512-899-2205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "TERRY",
"credential": "LCDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-17",
"last_updated": "2022-03-17",
"certification_date": "2022-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "15547",
"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 Mar 17, 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.