Dr William Dave Clark, PHD is a
Counselor - Mental Health based in Ellerslie, Georgia. Dr William Dave Clark is licensed to practice in Georgia (license number LPC001112) and his current practice location is
1421 Ossahatchie Creek Rd, Ellerslie, Georgia. He can be reached at his office (for appointments etc.) via phone at
(561) 319-0625.
NPI number for Dr William Dave Clark is 1023274503 and his current mailing address is 1421 Ossahatchie Creek Rd, Ellerslie, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023274503.
Healthcare Provider's Profile
| Full Name | Dr William Dave Clark |
|---|
| Gender | Male |
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| Speciality | Counselor - Mental Health |
|---|
| Location | 1421 Ossahatchie Creek Rd, Ellerslie, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1023274503
- Provider Enumeration Date: 08/04/2008
- Last Update Date: 08/04/2008
Medical Identifiers
Medical identifiers for Dr William Dave Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023274503 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | LPC001112 (Georgia) | 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. Dr William Dave 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 |
|---|
Dr William Dave Clark, PHD
1421 Ossahatchie Creek Rd,
Ellerslie, GA 31807-5339
Ph: (561) 319-0625 | Dr William Dave Clark, PHD
1421 Ossahatchie Creek Rd,
Ellerslie, GA 31807-5339
Ph: (561) 319-0625 |
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