GREGG PHILLIP CLARK PSS
NPI 1790414290
Peer Specialist in Louisa, KY
- Individual
- Male
- Peer Specialist
About GREGG CLARK
This page provides the complete NPI Profile along with additional information for Gregg Clark, a provider established in Louisa, Kentucky with a medical specialization in Peer Specialist. The healthcare provider is registered in the NPI registry with number 1790414290 assigned on June 2022. The practitioner's primary taxonomy code is 175T00000X. The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1790414290 Verify this NPI
- Provider Name
- GREGG PHILLIP CLARK PSS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 125 S MAIN CROSS ST LOUISA, KY 41230
- Location Phone
- (606) 639-0938
- Mailing Address
- 125 S MAIN CROSS ST LOUISA, KY 41230
- Mailing Phone
- (606) 639-0938
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-09-2022
- Last Update Date
- 06-09-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Peer Specialist
- Taxonomy Code
- 175T00000X
- Type
- Other Service Providers
- Taxonomy Description
- 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.
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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LOUISA, KY 41230
LOUISA, KY 41230
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790414290, enumerated as an "individual" on June 09, 2022.
The provider is located at 125 S MAIN CROSS ST LOUISA, KY 41230 and the phone number is (606) 639-0938.
Peer Specialist with taxonomy code 175T00000X.
