Wooldridge, Clark E
Wooldridge, Clark E is an individual health care provider with primary practice located at 1220 Mitchell , Clovis NM 88101. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wooldridge, Clark E can be contacted via phone (806) 681-6745.Contact Information
Primary practice address
1220 Mitchell
Clovis NM 88101
Phone: (806) 681-6745
Fax: (505) 742-3182
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I2267 | New Mexico |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 05339 | Texas |
Profile Details
| NPI number | 1649380502 |
|---|---|
| LBN Legal business name | Wooldridge, Clark E |
| Credentials | LISW ACP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 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 | 1649380502 | NPPES |
| New Mexico | MEDICAID | 97107 |
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