Dalia Clark, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH 9776 Issued in FL

Practice address

379 6TH Ave W
Bradenton, FL 34205-8820

Phone

(941) 782-4100

Fax

(941) 782-4101

NPI assigned

Jul 11, 2012

Last updated

Jul 11, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1902161326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9478",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342069478",
            "telephone_number": "941-782-4299",
            "fax_number": "941-782-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4100",
            "fax_number": "941-782-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DALIA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 9776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clapping Hands in Your Home
• Clarea, Inc. (Clarea Psychological Services)
• Clarity Psych Services
• Andrew Robert Clark, D.O.
• Angela C Clark, SLP
• Debra Diane Clark
• Elaine Rutherford Clark, LCSW
• Jennifer Michele Clark, LCSW
• Mary Ann Clark, PH.D.
• Melissa Kipp Clark, AU.D.

• Mental Health Counselor in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.