Linda Clark, LADC/MH CANDIDATE

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

76 Issued in OK

Practice address

16301 Sonoma Park Dr
Edmond, OK 73013-2091

Phone

(405) 748-0789

NPI assigned

Nov 23, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Linda Clark Ridenour 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": "1416700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1891192688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20433",
            "address_2": "PO BOX 20433",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731560433",
            "telephone_number": "405-748-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16301 SONOMA PARK DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730132091",
            "telephone_number": "405-748-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LINDA",
        "credential": "LADC/MH CANDIDATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-23",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "76",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OK",
            "license": "OCC-05967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "RIDENOUR",
            "middle_name": "CLARK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cimarron Rental, Inc.
• Dajashina Clark
• Debra Sue Clark, PT
• Grace Clark
• Lauren D'Ann Clark, NP
• Randolph Lynn Clark, DDS
• Shelbey Dawn Clark
• Kathryn Ann Clarkson, ARNP
• Zachary K Clary, M.D.
• Lazarus Classen, PTA

• Addiction (Substance Use Disorder) Counselor in Edmond, OK
• Providers in Edmond, OK by specialty
• Addiction (Substance Use Disorder) Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.