Patricia Ann Clark, PHD, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2004035218 Issued in MO

Practice address

112 S. Madison
Aurora, MO 65605

Phone

(866) 678-6233

NPI assigned

Nov 14, 2006

Last updated

Jul 8, 2007By 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

Doctor of Philosophy

State licenses

Practice roles

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.

• Lifecare Family Services Inc

  • Professional Counselor
  • Aurora, MO
  • NPI 1114070885
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942372248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 E CARDINAL ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046757",
            "telephone_number": "417-343-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S. MADISON",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "65605",
            "telephone_number": "866-678-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2004035218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Counseling and Therapeutic Services, LLC
• Center for Life Coaching and Counseling, LLC
• Charles L.. Chambers, DDS
• Children's Smile Center
• Chiropractic Center
• Kelley Coggin, CRNA
• Community Care Center of Aurora, Inc (Aurora Nursing Center)
• Community Residence, Inc. (Hudson House)
• John Thomas Compton, PA-C
• Darren Gene Cook, M.S.

• Professional Counselor in Aurora, MO
• Providers in Aurora, MO by specialty
• Professional Counselor in Missouri

• 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.