Gary Mike Clark, L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

KY-0272 Issued in KY

Practice address

8911 3Rd Street Rd
Louisville, KY 40272-2501

Phone

(502) 523-5433

NPI assigned

Mar 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912022484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8014 RED BUD HILL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402282215",
            "telephone_number": "502-523-5433",
            "fax_number": "502-239-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8911 3RD STREET RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402722501",
            "telephone_number": "502-523-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GARY",
        "middle_name": "MIKE",
        "name_prefix": "Dr.",
        "credential": "L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "KY-0272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Clark
• Donald Patrick Clark Jr., PHARMD
• Eleanor Irene Clark, M.A., CCC-SLP
• Elizabeth Clark, PA-C
• Emily Anne Clark, PT
• Gina Clark, APRN
• Grace Clark, DVM
• Jameel Tamir Clark, M.D.
• Jason S. Clark, D.V.M.
• Jeremy Dustin Clark, M.D.

• Marriage & Family Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Marriage & Family Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.