ERIC VINCESON CLARK SR. (NPI# 1588194583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588194583 |
Entity Type | Individual |
Full Name | ERIC VINCESON CLARK SR. |
Practice Address |
404 Hearne Ave Shreveport LA 71103-2022 |
Practice Telephone | (318) 716-1369 |
Practice Fax Number | 3186750120 |
Mailing Telephone | 3187161369 |
Mailing Fax Number | 3186750120 |
Enumeration Date | 2017-06-13 |
Last Update Date | 2017-06-13 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457917767 | Eric Clark | Dentist | 2597 Schoenersville Rd # A&301b, Bethlehem, PA 18017-7325 | 2019-05-13 |
1558429241 | Eric Walter Clark | Family Medicine | Mtsu Student Health, 1500 Greenland Ave Box 237, Murfreesboro, TN 37132-0001 | 2006-12-05 |
1780751453 | Eric M Clark | Chiropractor | 500 San Juan St, Trinidad, CO 81082-2517 | 2006-11-29 |
1679173710 | Eric Deon Clark | Counselor | 433 Turk St, San Francisco, CA 94102-3329 | 2020-10-28 |
1013553494 | Eric Christopher Clark | Registered Nurse | 1211 Medical Center Dr, Nashville, TN 37232-0004 | 2019-11-21 |
1043777204 | Eric Clark | Social Worker | 2711 Colonial Dr, Columbia, SC 29203-6818 | 2019-02-25 |
1740752260 | Eric Delancey Clark | Social Worker | 12 Southern Ave, Boston, MA 02124-2012 | 2018-12-21 |
1912496282 | Eric B Clark Jr. | Chiropractor | 10725 Abercorn St Apt 143, Savannah, GA 31419-1441 | 2018-05-02 |
1508370610 | Eric Robert Clark | Social Worker | 1131 Broadway St, Buffalo, NY 14212-1501 | 2017-11-28 |
1295283430 | Eric Charles Clark | Social Worker | 1608 Lake St, Kalamazoo, MI 49001-3170 | 2016-09-16 |
Street Address |
404 HEARNE AVE |
City | SHREVEPORT |
State | LA |
Zip Code | 71103-2022 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437546991 | Rising Up Family Services, LLC | Community/Behavioral Health | 404 Hearne Ave, Shreveport, LA 71103-2022 | 2015-04-22 |
1275170607 | Right Turn, LLC | Non-emergency Medical Transport (VAN) | 404 Hearne Ave, Shreveport, LA 71103-2022 | 2019-12-04 |
1295211480 | Kimberly Dawn Johnson | Case Manager/Care Coordinator | 404 Hearne Ave, Shreveport, LA 71103 | 2018-07-11 |
1922590355 | Brooke Lewis | Case Manager/Care Coordinator | 404 Hearne Ave, Shreveport, LA 71103 | 2018-06-01 |
1366945669 | John Danzell | Case Manager/Care Coordinator | 404 Hearne Ave, Shreveport, LA 71103 | 2018-03-13 |
1013421056 | James Ford | Case Manager/Care Coordinator | 404 Hearne Ave, Shreveport, LA 71103 | 2017-11-29 |
1184134983 | Delton Abrams | Social Worker | 404 Hearne Ave, Shreveport, LA 71103-2022 | 2017-10-05 |
1841718301 | Rendy Allen | Case Manager/Care Coordinator | 404 Hearne Ave, Shreveport, LA 71103 | 2017-09-05 |
1225572514 | Demetris Pillows | Case Manager/Care Coordinator | 404 Hearne Ave, Shreveport, LA 71103 | 2016-12-06 |
1376087684 | Cynthia Wilson | Counselor | 404 Hearne Ave, Shreveport, LA 71103-2022 | 2016-12-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
Find all providers in zip 71103 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639786502 | Erik Rasmussen | Counselor | 670 Albemarle Dr Ste 700, Shreveport, LA 71106-5946 | 2020-09-25 |
1043842750 | Creative Community Counseling LLC | Counselor | 2920 Knight St Ste 131, Shreveport, LA 71105-2412 | 2020-02-11 |
1477191591 | Keona Chequise Kidd | Counselor | 2829 Dunlap St, Shreveport, LA 71103-2244 | 2019-12-19 |
1336781632 | A New Beginning Counseling Services, LLC | Counselor | 9441 Oleander Dr, Shreveport, LA 71118-4008 | 2019-10-08 |
1841840311 | Theresa Davidson Snow | Counselor | 820 Jordan St Ste 510w, Shreveport, LA 71101-4526 | 2019-09-17 |
1962057737 | Mariana Penny | Counselor | 152 E College St, Shreveport, LA 71104-2510 | 2019-08-07 |
1528622818 | Kendal Redel | Counselor | 10011 Hanover Dr, Shreveport, LA 71115-3430 | 2019-04-23 |
1962960351 | Brandon Lewis-graham | Counselor | 3201 Knight St Apt 2206, Shreveport, LA 71105-2749 | 2019-03-05 |
1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
1659840312 | Donna Brown Franks | Counselor | 236 E Gregg St, Shreveport, LA 71104-5119 | 2018-11-24 |
Find all providers in SHREVEPORT |
City | SHREVEPORT |
Zip Code | 71103 |
Please comment or provide details below to improve the information on ERIC VINCESON CLARK SR..
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.