ERIC VINCESON CLARK SR.


Address: 404 Hearne Ave, Shreveport, LA 71103-2022
Phone: (318) 716-1369

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers

Other Providers ERIC CLARK

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

Office Location

Street Address 404 HEARNE AVE
City SHREVEPORT
State LA
Zip Code 71103-2022

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City SHREVEPORT
Zip Code 71103

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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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