Fred R Clark, LSW is a
Counselor - Professional based in Dunbar, West Virginia. Fred R Clark is licensed to practice in West Virginia (license number 1704) and his current practice location is
1020 Grosscup Ave, Dunbar, West Virginia. He can be reached at his office (for appointments etc.) via phone at
(304) 525-7851.
NPI number for Fred R Clark is 1992894992 and his current mailing address is 107 Summerbrook Lane, Hurricane, West Virginia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1992894992.
Healthcare Provider's Profile
Full Name | Fred R Clark |
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Gender | Male |
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Speciality | Counselor - Professional |
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Location | 1020 Grosscup Ave, Dunbar, West Virginia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1992894992
- Provider Enumeration Date: 10/11/2006
- Last Update Date: 02/27/2008
Medical Identifiers
Medical identifiers for Fred R Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992894992 | NPI | - | NPPES |
AP00941076 | Other | WV | LSW |
1704 | Other | WV | LPC |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | AP00941076 (West Virginia) | Secondary |
101YP2500X | Counselor - Professional | 1704 (West Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fred R Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Fred R Clark, LSW 107 Summerbrook Lane, Hurricane, WV 25526 Ph: (304) 525-7851 | Fred R Clark, LSW 1020 Grosscup Ave, Dunbar, WV 25064-3128 Ph: (304) 525-7851 |
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