GWENDOLYN D CLARK LCSW NPI 1588620538

NPI Information

NPI: 1588620538
Provider Name: GWENDOLYN D CLARK, LCSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
218 HOLIDAY HILLS DR
WILMINGTON, NC
ZIP 28409
Phone: (910) 612-0782
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Gwendolyn D Clark, LCSW is a mental health counselor in Wilmington, NC. Gwendolyn D Clark, LCSW NPI is 1588620538. 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:

218 HOLIDAY HILLS DR
WILMINGTON, NC
ZIP 28409-514
Phone: (910) 612-0782

The enumeration date for this NPI number is 4/26/2006 and was last updated on 3/11/2010.

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
1	101YM0800X	Counselor	Mental Health	C002055	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1312U	OTHER	NORTH CAROLINA	BCBS #
2	6106158	MEDICAID	NORTH CAROLINA
3	C002055	OTHER	NORTH CAROLINA	LICENSE

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: 4/28/2024

NPI Synchronization or Removal

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