Clark, Gregory James

Clark, Gregory James is an sole proprietor health care provider with primary practice located at 2656 W State St Suite 506, Olean NY 14760-1871. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Clark, Gregory James can be contacted via phone (716) 378-1002.

Contact Information

Primary practice address
2656 W State St Suite 506 Olean NY 14760-1871
Phone: (716) 378-1002
Fax: (716) 373-2170
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R073675-1 New York

Profile Details

NPI number 1558449843
LBN Legal business name Clark, Gregory James
Credentials LCSW-R
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558449843 NPPES
New York Other 000590314001 BLUE CROSS BLUE SHIELD

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