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:
Health care specialties
| Specialty | Code | License # | 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 18 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 | 1558449843 | NPPES |
| New York | Other | 000590314001 | BLUE CROSS BLUE SHIELD |
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