Gregory Scott Clark Jr.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

78242 Issued in TX

Practice address

1121 E Southeast Loop 323 Ste 204
Tyler, TX 75701

Phone

(903) 581-0933

Fax

(903) 581-0933

NPI assigned

Mar 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ron L. Roberts, M.S., P.C.

  • Professional Counselor
  • Tyler, TX
  • NPI 1598306581
  NPD
• Tyler Counseling & Assessment Center

  • Psychologist
  • Tyler, TX
  • NPI 1659483840

  Addiction (Substance Use Disorder)

  NPD
• Vcounselors PLLC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1326784307
  NPD

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1881055911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E SOUTHEAST LOOP 323 STE 204",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019660",
            "telephone_number": "903-581-0933",
            "fax_number": "903-581-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E SOUTHEAST LOOP 323 STE 204",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-581-0933",
            "fax_number": "903-581-0933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13207 Wright Rd",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "78610",
            "country_code": "US",
            "telephone_number": "512-697-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13207 Wright Rd",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "78610",
            "country_code": "US",
            "telephone_number": "512-697-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-17",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "31769",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "78242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Tibiletti MD PA
• Samantha Clakley
• Cade Wesley Clark, MD
• Carey Alexander Clark III, MD
• Cheryl K Clark
• James T. Clark, M.D.
• Jennifer Clark
• Kendrick Clark
• Lauren Clark, MS, RD, LD, CNSC
• Miranda Clark

• Professional Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.