GRACIA CLARK NPI 1417602251

NPI Information

  • NPI: 1417602251
  • Provider Name: GRACIA CLARK
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 403 STAGELINE RD
    HUDSON, WI
    ZIP 54016
  • Phone: (715) 531-6700

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NPI Details

Gracia Clark is a professional counselor in Hudson, WI with 7 years of experience. Gracia Clark NPI is 1417602251. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

403 STAGELINE RD
HUDSON, WI
ZIP 54016-848
Phone: (715) 531-6700

The NPI 1417602251 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/21/2022 and was last updated on 5/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselor8447WISCONSINNo
2101YP2500XCounselorProfessional8447WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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