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MR. BRADLEY DEWAYNE CLARK
NPI 1457008955
Peer Specialist in Tulsa, OK

Active since March 04, 2022
252 W 17TH PL, TULSA, OK 74119(918) 200-9065(918) 585-9543 Get Directions Write a Review

NPPES record last updated: March 4, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Bradley Dewayne Clark NPPES

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

MR. BRADLEY DEWAYNE CLARK (NPI 1457008955) is an individual peer specialist in Tulsa, Oklahoma and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1457008955
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameMR. BRADLEY DEWAYNE CLARK
Location Address252 W 17TH PLTulsa, OK 74119-4654
Mailing Address1620 S Elwood Ave Apt L3Tulsa, OK 74119-4252 · (214) 603-3301 · Fax (918) 585-9543
Phone(918) 200-9065
Fax(918) 585-9543
Sole ProprietorNo
Enumeration DateMarch 4, 2022
NPPES CertifiedMarch 4, 2022
✔ NPI 1457008955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

252 W 17TH PL, Tulsa, OK 74119
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Other Providers at the Same Location NPPES 15

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

CHARLOTTE SMITH
Counselor (Mental Health)
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 585-1213
STEVEN HUNTER PRSS
Peer Specialist
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 382-2470
LYNN M WILSON LMSW
Social Worker
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 382-2470
TERA SHAWN BRYANT
Specialist
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 378-5404
JULIE MARIE TATE
Peer Specialist
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 585-9543
AMANDA ELAINE PIPPIN PRSS
Peer Specialist
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 382-2435
MEGAN CROCKER
Peer Specialist
252 W 17TH PL
TULSA, OK 74119
Tulsa County (918) 313-3018
TIMOTHY RUTLEDGE
Peer Specialist
252 W 17TH PL
TULSA, OK 74119
Tulsa County (512) 297-7715

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Clark's NPI number?

The NPI number for Bradley Clark is 1457008955. It was assigned to this individual provider in the NPPES registry on March 4, 2022.

Where is Bradley Clark located?

Bradley Clark practices at 252 W 17th Pl, Tulsa, OK 74119. The listed phone number is (918) 200-9065.

What is Bradley Clark's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Bradley Clark was last updated on March 4, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.