Arc House of Elavation Inc of Thomasville

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ARC HOUSE OF ELAVATION INC OF THOMASVILLE

Practice address

127 Smith Ave Ste F
Thomasville, GA 31792-5593

Phone

(229) 236-1449

Fax

(229) 236-1869

NPI assigned

Oct 2, 2023

Last updated

Oct 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ardria Lynn Clark, LPCNPI 1518350743

Title

Owner

Phone

(229) 403-7047

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ardria Clark, LPC

  • Professional Counselor
  • Thomasville, GA
  • NPI 1518350743
  NPD Authorized official

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1992585483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HAYDEN WAY",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317920316",
            "telephone_number": "229-403-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SMITH AVE STE F",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925593",
            "telephone_number": "229-236-1449",
            "fax_number": "229-236-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARC HOUSE OF ELAVATION INC OF THOMASVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ARDRIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-403-7047",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.