MICHELE C CLARK (NPI# 1215303995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215303995 |
| Entity Type | Individual |
| Full Name | MICHELE C CLARK |
| Credential | CADC-I |
| Practice Address |
18612 Santa Ana Ave Bloomington CA 92316-2636 |
| Mailing Address |
940 Avenue 64 Pasadena CA 91105-2711 |
| Practice Telephone | 9094217120 |
| Mailing Telephone | 3232542274 |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2018-03-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124163860 | Michele Quinlan Clark | Counselor | 167 Washington St Ste 42, Norwell, MA 02061-1797 | 2007-02-20 |
| 1255932299 | Michele May Clark | Counselor | 10800 Financial Centre Pkwy Ste 290, Little Rock, AR 72211-3581 | 2020-11-05 |
| 1679955785 | Michele Clark | Physical Therapist | 790 N Highway 67 St, Florissant, MO 63031-5108 | 2015-06-25 |
| 1346596921 | Michele Poole Clark | Advanced Practice Midwife | 2500 Hospital Blvd, Suite 290, Roswell, GA 30076-4907 | 2012-08-01 |
| 1326326729 | Michele J Clark | Counselor | 289 Independence Blvd, Ste 245, Virginia Beach, VA 23462-5493 | 2011-08-02 |
| 1255591483 | Michele Clark | Social Worker | 17321 Telegraph Rd, Detroit, MI 48219-3132 | 2008-06-11 |
| 1134339740 | Michele Lynn Clark | Case Manager/Care Coordinator | 2040 Sutter Pl, Davis, CA 95616-6201 | 2007-05-23 |
| 1568587871 | Michele Lee Clark | Home Health Aide | 200 Sycamore St, Chillicothe, OH 45601-2653 | 2007-03-20 |
| 1922134147 | Michele Clark | Speech-Language Pathologist | 245 Lawn Market, Sharpsburg, GA 30277-1511 | 2007-02-23 |
| 1013066711 | Michele Clark | Counselor | 25 Court St, Montpelier, VT 05602-2812 | 2007-01-10 |
| Street Address |
18612 SANTA ANA AVE |
| City | BLOOMINGTON |
| State | CA |
| Zip Code | 92316-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942327820 | Emma Olivia Pintado | Licensed Vocational Nurse | 18612 Santa Ana Ave, Bloomington, CA 92316-2636 | 2007-03-23 |
| 1659971737 | Jennifer Doss | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-10-28 |
| 1619577137 | Charity Yvette Brown | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2636 | 2020-10-26 |
| 1265048979 | Brittany Wells | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-09-17 |
| 1881200590 | Samantha Bliss | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-09-17 |
| 1124633805 | Laurel Ann Dopp | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-09-10 |
| 1407469398 | Omara Moreno | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-08-28 |
| 1578173159 | Frank Joseph Vego | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-08-07 |
| 1366068611 | Leilani Santana Manzanares | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-06-23 |
| 1255966495 | Cheriss D Mixon | Counselor | 18612 Santa Ana Ave, Bloomington, CA 92316-2639 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811195001 | Raul A. Rodriguez Dds Inc. | Dentist | 9986 Bloomington, Bloomington, CA 92316 | 2007-07-10 |
| 1982706610 | Cathleen Helen Tapp Stewart | Dentist | 18601 Valley Boulevard, Bloomington, CA 92316 | 2006-09-02 |
| 1558840314 | Alexia Cisneros | Behavior Technician | 526 S Ironwood Ave, Bloomington, CA 92316-1218 | 2018-08-11 |
| 1295385235 | Angela Marie Sandoval | Technician | 857 S Ironwood Ave, Bloomington, CA 92316-1219 | 2019-09-11 |
| 1508348228 | Javier Sandoval Jr. | Dietitian, Registered | 516 S Linden Ave, Bloomington, CA 92316-1221 | 2018-08-29 |
| 1659746402 | Christina Kinney | Behavioral Analyst | 636 S Aspen Ave, Bloomington, CA 92316-1317 | 2015-12-04 |
| 1740634203 | Alfonso Luna IIi | Physician Assistant | 657 S Lancewood Ave, Bloomington, CA 92316-1336 | 2016-04-20 |
| 1881232650 | Sarah E Brown | Behavior Technician | 772 S Lancewood Ave, Bloomington, CA 92316-1343 | 2019-12-12 |
| 1073853255 | Alberta Frances Irons | Behavioral Analyst | 836 W Fontlee Ln, Bloomington, CA 92316-1508 | 2013-02-25 |
| 1073165650 | Genevieve Elon Monge | Family Medicine | 18651 Valley Blvd, Bloomington, CA 92316-1831 | 2019-07-12 |
| Find all providers in zip 92316 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917728 | Courtney Caryl Breyer | Counselor | 1701 American Blvd E Ste 4, Bloomington, MN 55425-1402 | 2020-06-17 |
| 1841832938 | Elizabeth Simon Simon | Counselor | 9193 S Greenridge Ln, Bloomington, IN 47401-9015 | 2019-10-10 |
| 1396220703 | Elizabeth Michelle Utterback | Counselor | 4633 W Richland Plaza Dr, Bloomington, IN 47404-9776 | 2018-10-02 |
| 1003316720 | William Douglas Portis | Counselor | 808 S Eldorado Rd Ste 100c, Bloomington, IL 61704-6075 | 2018-02-19 |
| 1346601804 | Colette Maureen Bisanz-haas | Counselor | 9301 Bryant Ave S Ste 107, Bloomington, MN 55420-3438 | 2016-03-11 |
| 1952791733 | Ryan Conway | Counselor | 900 E 7th St, M005, Bloomington, IN 47405-3905 | 2015-01-30 |
| 1629487749 | Deborah C Wilkin | Counselor | 455 E Wylie Farm Rd, Bloomington, IN 47401-4591 | 2014-08-04 |
| 1518208206 | Jeremy Keith Davis | Counselor | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2013-03-06 |
| 1053691717 | Finding Your Path To Freedom | Counselor | 2310 E Oakland Ave Ste 11b, Bloomington, IL 61701-5881 | 2011-08-25 |
| 1528376985 | Countermeasures, Inc. | Counselor | 110 N. Center, Bloomington, IL 61701-5002 | 2010-09-20 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 92316 |
Please comment or provide details below to improve the information on MICHELE C CLARK.
| 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.