Stacey Clark, SLP- ASSISTANT

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

33794 Issued in TX

Practice address

6301 Gaston Ave Ste 750
Dallas, TX 75214-3922

Phone

(214) 295-5374

NPI assigned

Jan 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Stacey Clark-Anderson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517097600000",
    "number": "1881192581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 AMHERST DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751151540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 GASTON AVE STE 750",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143922",
            "telephone_number": "214-295-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STACEY",
        "name_prefix": "Ms.",
        "credential": "SLP- ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-28",
        "last_updated": "2018-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "33794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "CLARK-ANDERSON",
            "prefix": "MRS.",
            "credential": "SLP-ASSISTANT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Scott Randall Clark, NP
• Shane Alan Clark, MD
• Shanice Clark
• Shannon Leah Clark, PHD
• Sherry Clark
• Stella I Clark
• Steven Anthony Clark, MD
• Steven Michael Clark, MD
• Sue Clark, LPC
• Tampa Catherine Clark, DNP, APRN, CNS

• Speech-Language Pathologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.