Healthcare Provider Details

I. General information

NPI: 1285582189
Provider Name (Legal Business Name): BELINDA K CLARK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 FALLS AVE
GRANITE FALLS NC
28630-1509
US

IV. Provider business mailing address

207 8TH AVENUE DR SW
HICKORY NC
28602-3452
US

V. Phone/Fax

Practice location:
  • Phone: 828-461-8524
  • Fax:
Mailing address:
  • Phone: 813-305-9428
  • Fax: 804-773-6427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberNA
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: