Fred R Clark, LSW in Dunbar, WV - Counselor

Fred R Clark, LSW is a Counselor - Professional based in Dunbar, West Virginia. Fred R Clark is licensed to practice in West Virginia (license number 1704) and his current practice location is 1020 Grosscup Ave, Dunbar, West Virginia. He can be reached at his office (for appointments etc.) via phone at (304) 525-7851.

NPI number for Fred R Clark is 1992894992 and his current mailing address is 107 Summerbrook Lane, Hurricane, West Virginia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1992894992.

Contact Information

	Fred R Clark, LSW
	1020 Grosscup Ave, Dunbar, WV 25064-3128
	(304) 525-7851
	(304) 525-1073

Healthcare Provider's Profile

Full Name	Fred R Clark
Gender	Male
Speciality	Counselor - Professional
Location	1020 Grosscup Ave, Dunbar, West Virginia
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1992894992
Provider Enumeration Date: 10/11/2006
Last Update Date: 02/27/2008

Medical Identifiers

Medical identifiers for Fred R Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992894992	NPI	-	NPPES
AP00941076	Other	WV	LSW
1704	Other	WV	LPC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	AP00941076 (West Virginia)	Secondary
101YP2500X	Counselor - Professional	1704 (West Virginia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fred R Clark is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Fred R Clark, LSW 107 Summerbrook Lane, Hurricane, WV 25526 Ph: (304) 525-7851	Fred R Clark, LSW 1020 Grosscup Ave, Dunbar, WV 25064-3128 Ph: (304) 525-7851

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Fred R Clark, LSW - in Dunbar, WV