ABRAHAM LEWIS CLARK
NPI 1720401367
Counselor - Addiction (Substance Use Disorder) in Santa Rosa, CA

Q: What is Abraham Clark's NPI number?

The NPI number for Abraham Clark is 1720401367. It was assigned to this individual provider in the NPPES registry on February 3, 2014.

Q: What is Abraham Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Abraham Clark was last updated on February 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 February 03, 2014

1901 CLEVELAND AVENUE, #B, SANTA ROSA TREATMENT PROGRAM, SANTA ROSA, CA 95401(707) 576-0818 Get Directions Write a Review

NPPES record last updated: February 3, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Abraham Lewis Clark NPPES

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

ABRAHAM LEWIS CLARK (NPI 1720401367) is an individual addiction (substance use disorder) provider in Santa Rosa, California, licensed in California (RIC1401231658) and active in the NPI registry since February 2014.

NPPES Registry Identity

NPI1720401367

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameABRAHAM LEWIS CLARK

Location Address1901 CLEVELAND AVENUE, #B, SANTA ROSA TREATMENT PROGRAMSanta Rosa, CA 95401

Mailing Address1901 Cleveland Avenue, #b, Santa Rosa Treatment ProgramSanta Rosa, CA 95401 · (707) 576-0818 · Fax (707) 576-7845

Phone(707) 576-0818

Sole ProprietorNo

Enumeration DateFebruary 3, 2014

✔ NPI 1720401367 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 CA · RIC1401231658

Other Providers at the Same Location NPPES 2

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

KELLY GOING LVN

Licensed Vocational Nurse

1901 CLEVELAND AVENUE, #B, SANTA ROSA TREATMENT PROGRAM
SANTA ROSA, CA 95401

Sonoma County (707) 576-0818

MR. ANDY LEROY FULTON JR. RAS

Counselor (Addiction (Substance Use Disorder))

1901 CLEVELAND AVENUE, #B
SANTA ROSA, CA 95401

Sonoma County (707) 576-0818

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 Abraham Clark's NPI number?

The NPI number for Abraham Clark is 1720401367. It was assigned to this individual provider in the NPPES registry on February 3, 2014.

Where is Abraham Clark located?

Abraham Clark practices at 1901 Cleveland Avenue, #b Santa Rosa Treatment Program, Santa Rosa, CA 95401. The listed phone number is (707) 576-0818.

What is Abraham Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Abraham Clark was last updated on February 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.