DOUGLAS CLARK PRSS
NPI 1548039340
Peer Specialist in Saint Albans, WV

Q: What is Douglas Clark's NPI number?

The NPI number for Douglas Clark is 1548039340. It was assigned to this individual provider in the NPPES registry on December 21, 2023.

Q: What is Douglas Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Douglas Clark was last updated on December 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 21, 2023

2333 MACCORKLE AVE STE 201, SAINT ALBANS, WV 25177(304) 766-0060 Get Directions Write a Review

NPPES record last updated: December 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Douglas Clark Prss NPPES

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

DOUGLAS CLARK PRSS (NPI 1548039340) is an individual peer specialist in Saint Albans, West Virginia, licensed in West Virginia (23-9200) and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1548039340

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameDOUGLAS CLARKCredential: PRSS

Location Address2333 MACCORKLE AVE STE 201Saint Albans, WV 25177-2074

Mailing Address2333 Maccorkle Ave Ste 201Saint Albans, WV 25177-2074 · (304) 766-0060

Phone(304) 766-0060

Sole ProprietorNo

Enumeration DateDecember 21, 2023

Last NPPES UpdateDecember 28, 2023

NPPES CertifiedDecember 28, 2023

✔ NPI 1548039340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in WV · 23-9200

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.

2333 MACCORKLE AVE STE 201, Saint Albans, WV 25177

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Other Providers at the Same Location NPPES 20

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

JONATHAN SULLIVAN PRSS

Peer Specialist