Clark, Edward
Clark, Edward is an individual health care provider with primary practice located at 121 E Elwood Ave , Raeford NC 28376-2947. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Clark, Edward can be contacted via phone (910) 875-8156.Contact Information
Primary practice address
121 E Elwood Ave
Raeford NC 28376-2947
Phone: (910) 875-8156
Fax: (910) 875-5579
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C000989 | North Carolina |
Profile Details
| NPI number | 1235146697 |
|---|---|
| LBN Legal business name | Clark, Edward |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Mar 25th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235146697 | NPPES |
| North Carolina | MEDICAID | 6003566 |
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