Active NPI
Will Clark, MS, APC, NCC
- Professional Counselor
- Snellville, GA
National Provider Identifier
1770149619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APC006757
- Practice address
- 2336 Wisteria Dr Ste 440
Snellville, GA 30078-6160 - Phone
- (404) 664-7494
- NPI assigned
- May 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC006757 | GA | Primary |
Addresses
Primary practice location
2336 Wisteria Dr Ste 440
Snellville, GA 30078-6160
Mailing address
3228 Kings Bay Cir
Decatur, GA 30034-7123
Phone (404) 664-7494
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APC006757 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1770149619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3228 KINGS BAY CIR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300347123",
"telephone_number": "404-664-7494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2336 WISTERIA DR STE 440",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300786160",
"telephone_number": "404-664-7494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "WILL",
"credential": "MS, APC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-16",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "APC006757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.