RICHARD JACK CLARK


Address: 68 S 600 E, Salt Lake City, UT 84102-1007
Phone: 8014283244

RICHARD JACK CLARK (NPI# 1316393283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316393283
Entity Type Individual
Full Name RICHARD JACK CLARK
Credential PEER SUPPORT
Practice Address 68 S 600 E
Salt Lake City
UT 84102-1007
Practice Telephone 8014283244
Mailing Telephone 8014283244
Enumeration Date 2016-05-10
Last Update Date 2016-05-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist #518 UT Other Service Providers

Other Providers RICHARD CLARK

NPI Name Taxonomy Address Enumeration
1366922684 Richard Sheldon Clark Counselor 311 Penny Dr, Lithopolis, OH 43136-9704 2018-08-16
1871929000 Richard H Clark Chiropractor 462 Warren Rd, Franklin, PA 16323-6544 2013-09-19
1770831901 Richard Clark Counselor 2902 Jack Pine St, Bellevue, NE 68123-5519 2012-08-20
1285866079 Richard C Clark IIi Counselor 800 Pineview Dr, Hattiesburg, MS 39401-7459 2009-08-13
1134318140 Richard S Clark Marriage & Family Therapist 2801 Summit St Apt 307, Oakland, CA 94609-3643 2007-10-16
1023042470 Richard R. Clark Family Medicine 1475 E Belvidere Rd Unit 385, Grayslake, IL 60030-2026 2006-07-10
1942249545 Richard James Clark IIi Dentist 2300 Garrett Rd, Drexel Hill, PA 19026-1102 2006-06-06
1699744011 Richard C Clark Physical Therapist 4909 Nolensville Rd, Nashville, TN 37211-5411 2006-03-16
1528059565 Richard K Clark Optometrist 810 Ne 25th Ave, Ocala, FL 34470-6335 2005-10-31
1053316364 Richard Don Clark Family Medicine 802 Wayne St, Ste 202, Marietta, OH 45750-3300 2005-06-15

Office Location

Street Address 68 S 600 E
City SALT LAKE CITY
State UT
Zip Code 84102-1007

Providers in the same location

NPI Name Taxonomy Address Enumeration
1841519402 Michael David Dulle Counselor 68 S 600 E, Salt Lake City, UT 84102-1007 2010-05-21
1023615044 Brook Sharp Shipley Case Manager/Care Coordinator 68 S 600 E, Salt Lake City, UT 84102-1007 2020-10-02
1467064253 Michael E Nope Counselor 68 S 600 E, Salt Lake City, UT 84102-1007 2020-08-21
1942811948 Andres Demecio Montoya Case Manager/Care Coordinator 68 S 600 E, Salt Lake City, UT 84102-1007 2020-08-12
1013528009 Windell Tsabetsaye Hitlall Case Manager/Care Coordinator 68 S 600 E, Salt Lake City, UT 84102-1007 2020-08-12
1528676939 Jami Bailey Peer Specialist 68 S 600 E, Salt Lake City, UT 84102-1007 2020-07-21
1538531785 Catherine Lea Sharp Community Health Worker 68 S 600 E, Salt Lake City, UT 84102-1007 2015-10-28
1104265537 Odyssey House Corp Substance Abuse Rehabilitation Facility 68 S 600 E, Salt Lake City, UT 84102-1007 2013-06-19
1134466683 Jessica Lyn Cowan Community Health Worker 68 S 600 E, Salt Lake City, UT 84102-1007 2013-01-03
1093007254 Anya Brennan Case Manager/Care Coordinator 68 S 600 E, Salt Lake City, UT 84102-1007 2011-05-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942818604 Wendy Vazquez Behavior Technician 515 S 700 E Suit 2a, Salt Lake City, UT 84102 2020-07-20
1407481245 Odyssey House Inc Family Medicine 743 E 300 S, Salt Lake City, UT 84102 2020-03-11
1093359960 Hayle Mayer Behavior Technician 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 2019-11-04
1326680869 Ronald Mcdonald House of The Intermountain Area Meals 935 E. South Temple, Salt Lake City, UT 84102 2019-10-16
1508419581 Claire Pemberton Behavior Technician 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 2019-07-19
1558923144 Olivia Anne Hardwick Social Worker Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 2019-07-03
1649741802 Colten Vancampen Behavior Technician 515 S 700 E #2a, Salt Lake City, UT 84102 2018-12-16
1457847964 Utah Podiatry Group PC Podiatrist 24 S 1100 E Ste 120, Salt Lake City, UT 84102 2018-07-09
1104311661 Malorey Kooyman Behavior Technician 515 700 East, Suite 2a, Salt Lake City, UT 84102 2018-06-27
1700384930 Utah Podiatry Group PC Podiatrist 82 S 1100 E Ste 301, Salt Lake City, UT 84102 2018-01-23
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Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043819600 Devin J Morrison Peer Specialist 230 W 200 S Unit 142, Salt Lake City, UT 84110-6006 2020-10-23
1518579077 Henry Matthews Peer Specialist 474 N Grant St, Salt Lake City, UT 84116-2726 2020-08-17
1134780042 Michael James Olsen Peer Specialist 344 E 100 S Ste 301300, Salt Lake City, UT 84111-1700 2019-06-23
1659836393 Brittney Emi Vaovasa Peer Specialist 252 W Brooklyn Ave, Salt Lake City, UT 84101-3024 2019-02-06
1306348263 Kurt Kyle Landenberger Peer Specialist 2200 S State St Fl 2, Salt Lake City, UT 84115-2724 2018-03-06
1922609320 Teri Christensen Peer Specialist 230 W 200 S # 142, Salt Lake City, UT 84101-1337 2020-11-03
1821698713 Kim Katherine Stephens Peer Specialist 230 W 200 S # 142, Salt Lake City, UT 84101-1337 2020-10-29
1225638364 Anna Elizabeth Dees Peer Specialist 230 W 200 S Ste 142, Salt Lake City, UT 84101-1337 2020-10-28
1124628268 Amber Wilkins I Peer Specialist 230 W 200 S # 142, Salt Lake City, UT 84101-1337 2020-10-28
1811596885 Kaylie A Larsen Peer Specialist 230 W 200 S # 142, Salt Lake City, UT 84101-1337 2020-10-21
Find all providers in SALT LAKE CITY

Competitor

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City SALT LAKE CITY
Zip Code 84102

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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