Clark, John D.

Clark, John D. is an individual health care provider with primary practice located at 235 S Water St , Martinsburg WV 25401-4241. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Clark, John D. can be contacted via phone (304) 263-8954.

Contact Information

Primary practice address
235 S Water St Martinsburg WV 25401-4241
Phone: (304) 263-8954
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 6401007651 Michigan

Profile Details

NPI number 1235223041
LBN Legal business name Clark, John D.
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jan 15th, 2014 - about 11 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 1235223041 NPPES
West Virginia MEDICAID 0023817001

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