JAMES A CLARK CADCIII - NPI 1356365316 - Counselor in Fort Atkinson, WI

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

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About James A Clark Cadciii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES A CLARK CADCIII (NPI 1356365316) is an individual addiction (substance use disorder) provider in Fort Atkinson, Wisconsin, licensed in Wisconsin (484) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1356365316

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameJAMES A CLARKCredential: CADCIII

Location Address509 MCMILLEN STFort Atkinson, WI 53538-1263

Mailing Address509 Mcmillen StFort Atkinson, WI 53538-1263 · (920) 563-7995 · Fax (920) 568-6047

Phone(920) 563-7995

Fax(920) 568-6047

Sole ProprietorNo

Enumeration DateJuly 26, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1356365316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in WI · 484

509 MCMILLEN ST, Fort Atkinson, WI 53538

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Other Identifiers 1

Medicaid39344700WI

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICHOLAS J BISENIUS PHD

Psychologist