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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | #518 | UT | Other Service Providers |
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 |
Street Address |
68 S 600 E |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84102-1007 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 84102 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
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] |
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 |
City | SALT LAKE CITY |
Zip Code | 84102 |
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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.