MARY CATHERINE CLARK (NPI# 1063865186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063865186 |
| Entity Type | Individual |
| Full Name | MARY CATHERINE CLARK |
| Credential | MS, BSL, BSC, MT |
| Practice Address |
62 Plaza Ln Wellsboro PA 16901-1766 |
| Mailing Address |
1 W Main St Fleetwood PA 19522-1323 |
| Practice Telephone | 5707247142 |
| Practice Fax Number | 5707246771 |
| Mailing Telephone | 6109440445 |
| Mailing Fax Number | 6109448834 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
BH003138 | PA | Ambulatory Health Care Facilities |
| Street Address |
62 PLAZA LN |
| City | WELLSBORO |
| State | PA |
| Zip Code | 16901-1766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568646370 | Concern-professional Services for Children, Youth & Families | Nursing Care | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2007-12-28 |
| 1902428469 | Joleen Rae George | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2020-05-07 |
| 1184194219 | Jason R Fry | Counselor | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2018-12-02 |
| 1982185690 | George David Pitre | Counselor | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2018-08-22 |
| 1427401934 | Kimberly Allen | Counselor | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2016-07-20 |
| 1316345226 | Richard Hayford | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-12-09 |
| 1609287184 | Trinity Dawn Cowburn | Counselor | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-05-19 |
| 1841613692 | Pamela Suanne Oliver | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-30 |
| 1164845848 | Kristina Mielke | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-30 |
| 1821411737 | Cathleen Marengo | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964940 | Alyssa Lapp | Occupational Therapist | 32 Central Avenue, Wellsboro, PA 16901 | 2019-07-19 |
| 1437701190 | Kari Donnele Root | Occupational Therapist | 36 Central Avenue, Wellsboro, PA 16901 | 2019-07-12 |
| 1205377835 | Brett Long | Physical Therapy Assistant | 37 Central Avenue, Wellsboro, PA 16901 | 2017-03-15 |
| 1487072526 | Mary Caitlin Jones | Physical Therapist | 100 Plaza Ln, Wellsboro, PA 16901 | 2014-04-05 |
| 1144650607 | Amy Chalot | Occupational Therapy Assistant | 1883 Shumway Hill Road, Broad Acres Health and Rehabilitation Center, Wellsboro, PA 16901 | 2013-11-20 |
| 1780844209 | Upmc Wellsboro | Pathology | 32 36 Central Avenue, Pathology, Wellsboro, PA 16901 | 2008-06-10 |
| 1639369606 | Well Adjusted Chiropractic Center PC | Chiropractor | 82 East Avenue, Wellsboro, PA 16901 | 2007-07-26 |
| 1538362991 | John W Eaton | Dentist | 23 Water Street, Wellsboro, PA 16901 | 2007-06-06 |
| 1437210242 | James Michael Stewart | Technician/Technologist | 16 Pearl St, Wellsboro, PA 16901 | 2006-12-13 |
| 1508879560 | Edward Jeffrey Candela | Dentist | 16 Water St, Wellsboro, PA 16901 | 2006-08-14 |
| Find all providers in zip 16901 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710538020 | Haven of Tioga County | Clinic/Center | 48 East Ave, Wellsboro, PA 16901-1714 | 2019-09-27 |
| 1417455510 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 32 Meade St, Wellsboro, PA 16901-1843 | 2018-01-24 |
| 1205334307 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 9 Nichols St, Wellsboro, PA 16901-1122 | 2018-01-24 |
| 1215279823 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 1768 Shumway Hill Rd, Wellsboro, PA 16901-6838 | 2013-03-21 |
| 1215435318 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 10 Sherman St, Wellsboro, PA 16901-1829 | 2018-01-24 |
| 1619412327 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 225 Nichols St, Wellsboro, PA 16901-1144 | 2017-01-04 |
| 1578829255 | Concern Professional Services for Children, Youth, & Families | Clinic/Center | 1873 Shumway Hill Rd, Wellsboro, PA 16901-6840 | 2012-04-06 |
| 1083889042 | North Penn Comprehensive Health Services | Clinic/Center | 32-36 Central Ave, Wellsboro, PA 16901-1840 | 2008-04-29 |
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| 1447857800 | Simple Healing LLC | Clinic/Center | 11 W 2nd St Unit 305, Bethlehem, PA 18015-1294 | 2020-10-07 |
| 1629683693 | Sunshine Counseling, LLC | Clinic/Center | 1093 Douglass Dr Apt A, Boyertown, PA 19512-7620 | 2020-09-15 |
| 1619582533 | Concern-professional Services for Children, Youth & Families | Clinic/Center | 749 South St, Laporte, PA 18626-7019 | 2020-09-09 |
| 1023623956 | Sunshine Healing & Counseling | Clinic/Center | 328 Summit Ave Ste 120, Jenkintown, PA 19046-3134 | 2020-09-08 |
| 1376153940 | Nami Erie County Pa | Clinic/Center | 1611 Peach St Ste 218, Erie, PA 16501-2121 | 2020-08-07 |
| 1376161919 | Bryan Bass-riley Licensed Professional Counselor, LLC | Clinic/Center | 3825 Northern Pike Ste 202, Monroeville, PA 15146-2161 | 2020-07-09 |
| 1053937664 | Theosis Therapeutic Counseling | Clinic/Center | 982 E Pine St, Palmyra, PA 17078-2821 | 2020-06-19 |
| 1366065633 | Let's Talk Counseling, LLC | Clinic/Center | 510 Springfield Rd, Aldan, PA 19018-4227 | 2020-05-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.