| Randy Gene Clark Sr, | |
|
1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | |
| (417) 308-0671 | |
| Not Available |
| Full Name | Randy Gene Clark Sr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1639 Bruce Smith Pkwy, West Plains, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063939817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 202404464 (Missouri) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Randy Gene Clark Sr, 45335 Sierra Hwy, Lancaster, CA 93534-1611 Ph: (661) 949-8599 | Randy Gene Clark Sr, 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 Ph: (417) 308-0671 |
Zachary Nelson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 412 Washington Ave, West Plains, MO 65775 Phone: 417-274-0469 Fax: 417-503-1442 | |
Jenna Hampton, PLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1211 Porter Wagoner Blvd, West Plains, MO 65775 Phone: 417-257-6762 | |
Mrs. Jeannie Rhoads-ashley, CCDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-256-2570 Fax: 417-256-6497 | |
Cretia Lynne Ussery, QMHP RADC-P Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-257-9152 | |
Rebecca Kay Beville, MA, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1211 Porter Wagoner Blvd, West Plains, MO 65775 Phone: 417-257-6762 | |
Kendell Pellham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-256-2570 |