Individual provider Active NPI

Delzora Mae Clark, MA, LCMHC, NCC

  • Counselor
  • New Bern, NC
National Provider Identifier
1871101436
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
313010 Issued in NC
Practice address
2002 S Glenburnie Rd Ste 4D
New Bern, NC 28562-5230
Phone
(252) 515-0896
Fax
(888) 649-2167
NPI assigned
Jul 20, 2020
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 313010 NC Primary

Addresses

Primary practice location

2002 S Glenburnie Rd Ste 4D
New Bern, NC 28562-5230

Mailing address

1822 S Glenburnie Rd
New Bern, NC 28562-5261
Phone (252) 349-9672

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL WWW.VoicedMania.com

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 Arts

State licenses

LicenseStateTypeSpecialty
313010NCMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1871101436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 S GLENBURNIE RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625261",
            "telephone_number": "252-349-9672",
            "fax_number": "888-649-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 S GLENBURNIE RD STE 4D",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625230",
            "telephone_number": "252-515-0896",
            "fax_number": "888-649-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DELZORA",
        "middle_name": "MAE",
        "credential": "MA, LCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "313010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.VoicedMania.com",
            "affiliation": "N",
            "address_1": "1822 S Glenburnie Rd",
            "city": "New Bern",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285625261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.