Lance Clark, MA, LCMHC, BCTMH, QS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

9217 Issued in NC

Practice address

320 N Judd Pkwy NE Ste 226
Fuquay Varina, NC 27526-2624

Phone

(919) 812-7535

NPI assigned

Jan 20, 2012

Last updated

Jun 9, 2022By the provider in NPPES

Sex

Male

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clark Christian Counseling, PLLC

  • Professional Counselor
  • Fuquay Varina, NC
  • NPI 1346869534
  NPD Authorized official

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1932470119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N JUDD PKWY NE STE 226",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262624",
            "telephone_number": "919-812-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N JUDD PKWY NE STE 226",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262624",
            "telephone_number": "919-812-7535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "547 Keisler Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275189309",
            "country_code": "US",
            "telephone_number": "919-812-7535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "543 Keisler Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275189321",
            "country_code": "US",
            "telephone_number": "919-812-7535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LANCE",
        "name_prefix": "Mr.",
        "credential": "MA, LCMHC, BCTMH, QS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-20",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "9217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunny Song Chung, DDS
• Darren A Ciccolini, PA-C
• Breah Claar, CCC-SLP
• Jacob Joel Clairmont, PA
• Clark Christian Counseling, PLLC
• Skylor Maxx Clark, LCSWA
• Rebecca Clarke, M.S., CCC-SLP
• Clearly Kommon LLC
• Michele Elane Clephane, L.M.B.T.
• Cameron Waters Clinard, OD

• Professional Counselor in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.