Heather Nicole Clark, MA, MFT

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

510 E Carolina Ave
Hartsville, SC 29550-4396

Phone

(843) 332-4156

Fax

(843) 332-4159

NPI assigned

May 22, 2018

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1861983116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504396",
            "telephone_number": "843-332-4156",
            "fax_number": "843-332-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504396",
            "telephone_number": "843-332-4156",
            "fax_number": "843-332-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "credential": "MA, MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond M Chapman, M.D.
• Childrens Group PC
• Chiropractic Solutions of Hartsville, LLC
• Christine a Ballenger PSYD LLC
• Barry Lee Clark, D.O.
• Clemson Eye, PA
• Danna Dubose Coe
• Samuel Pressly Coker III, LPC
• Community Health and Urgent Care LLC
• Compassionate Care of Hartsville

• All providers in Hartsville, SC
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.