Provider Demographics
NPI:1932270238
Name:WEST CLARK COMMUNITY SCHOOLS
Entity Type:Organization
Organization Name:WEST CLARK COMMUNITY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:812-246-3375
Mailing Address - Street 1:601 RENZ AVE
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-1331
Mailing Address - Country:US
Mailing Address - Phone:812-246-3375
Mailing Address - Fax:812-246-9731
Practice Address - Street 1:601 RENZ AVE
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172-1331
Practice Address - Country:US
Practice Address - Phone:812-246-3375
Practice Address - Fax:812-246-9731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN351752235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty