National Provider Identifier
Gregory James Clark, LCSW-R
Gregory James Clark, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Olean, NY and a listed phone number of (716) 378-1002.
Profile Overview
- NPI
- 1558449843
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- November 02, 2006
- Last Updated
- July 08, 2007
Practice Location
- 2656 W State St
- Suite 506
- Olean, NY 14760-1871
Phone: (716) 378-1002
Mailing Address
- 2608 Route 305
- Cuba, NY 14727-9555
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1558449843
- Entity Type
- Individual
- Last Name
- Clark
- First Name
- Gregory
- Middle Name
- James
- Credential
- LCSW-R
- Mailing Street Address
- 2608 Route 305
- Mailing City
- Cuba
- Mailing State
- NY
- Mailing ZIP Code
- 14727-9555
- Mailing Country
- US
- Mailing Phone
- (585) 968-3816
- Practice Street Address
- 2656 W State St
- Practice Address Line 2
- Suite 506
- Practice City
- Olean
- Practice State
- NY
- Practice ZIP Code
- 14760-1871
- Practice Country
- US
- Practice Phone
- (716) 378-1002
- Practice Fax
- (716) 373-2170
- Enumeration Date
- November 02, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)
- Other Identifiers
- 000590314001 (NY, Blue Cross Blue Shield)