| Gregory D. Clark, Msw, Llc | |
|
118 Broadway N Suite 810 Fargo ND 58102-4949 | |
| (701) 799-8785 | |
| (701) 205-4930 |
| Full Name | Gregory D. Clark, Msw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 118 Broadway N, Fargo, North Dakota |
| Authorized Official Name and Position | Gregory Darwin Clark (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7017998785 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory D. Clark, Msw, Llc 118 Broadway N Suite 810 Fargo ND 58102-4949 Ph: (701) 799-8785 | Gregory D. Clark, Msw, Llc 118 Broadway N Suite 810 Fargo ND 58102-4949 Ph: (701) 799-8785 |
| NPI Number | 1144600800 |
|---|---|
| Provider Enumeration Date | 06/08/2015 |
| Last Update Date | 06/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144600800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2973 (North Dakota) | Primary |
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