SEAN HOBAN CLARK (NPI# 1457864605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457864605 |
| Entity Type | Individual |
| Full Name | SEAN HOBAN CLARK |
| Other Name | SEAN ELIZABETH HOBAN |
| Practice Address |
2495 Maplewood Dr Ste 312 Maplewood MN 55109-1985 |
| Practice Telephone | 6517603109 |
| Practice Fax Number | 6519679417 |
| Mailing Telephone | 6517603109 |
| Mailing Fax Number | 6519679417 |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235681966 | Sean Clark | Pharmacist | 2407 Stringer Gap Rd, Grants Pass, OR 97527-9573 | 2016-10-28 |
| 1801126487 | Sean Clark | Podiatrist | 8757 Sharmead Way, Fair Oaks, CA 95628-6337 | 2010-01-05 |
| 1497979298 | Sean Clark | Specialist | 151 S College Ave, Suite A4, Fort Collins, CO 80524-2864 | 2007-04-12 |
| 1730283169 | Sean Paul Clark | Chiropractor | 3900 Campus Dr, Newport Beach, CA 92660-2206 | 2006-09-07 |
| 1194249029 | Sean William Clark | Pharmacist | 237 William Howard Taft Rd, Cincinnati, OH 45219-2610 | 2017-08-02 |
| 1689078271 | Sean Clark | Counselor | 707 Ne Couch St, Portland, OR 97232-2922 | 2014-10-10 |
| 1669682092 | Sean Joseph Clark | Student in an Organized Health Care Education/Training Program | 619 19th St S, Birmingham, AL 35249-1900 | 2007-05-23 |
| 1528034147 | Sean Clark | Technician, Health Information | 15 Mohegan Ave, Uscg Academy - Michel Hall, New London, CT 06320-8100 | 2006-02-24 |
| Street Address |
2495 MAPLEWOOD DR STE 312 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265791503 | Dynamic Connections, Inc. | Clinic/Center | 2495 Maplewood Dr Ste 312, Maplewood, MN 55109-1985 | 2012-05-07 |
| 1386259612 | Emma Worthley | Psychologist | 2495 Maplewood Dr Ste 312, Maplewood, MN 55109-1985 | 2020-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255383824 | James Peter Davig | Psychologist | 2688 Maplewood Dr, Maplewood, MN 55109-1021 | 2006-05-16 |
| 1386259612 | Emma Worthley | Psychologist | 2495 Maplewood Dr Ste 312, Maplewood, MN 55109-1985 | 2020-09-14 |
| 1912429606 | Helayne Berke | Psychologist | 2495 Maplewood Dr, Maplewood, MN 55109-1984 | 2017-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347854 | Shining Light Skill Building LLC | Psychologist | 3055 Old Highway 8 Ste 106b, St. Anthony, MN 55418 | 2020-08-17 |
| 1245750652 | Sara Vaccarella | Psychologist | 331 W Superior St Ste 300, Duluth, MN 55802-4532 | 2017-06-27 |
| 1780124305 | Families First Counseling Services LLC | Psychologist | 103 S Kingston St, Caledonia, MN 55921-1315 | 2017-03-01 |
| 1598150930 | Nova Bhs | Psychologist | 521 Tanglewood Dr., Shoreview, MN 55126 | 2015-04-02 |
| 1801208566 | Rose Mary Boerboom | Psychologist | 415 N 1st St, #502, Minneapolis, MN 55401-4305 | 2014-05-28 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1992145288 | Rowan P Buckley | Psychologist | 6825 Owen St Ste 201, Loretto, MN 55357-9713 | 2013-07-01 |
| 1063781771 | Julie Ann Gomer | Psychologist | 13700 Reimer Dr N Ste 220, Maple Grove, MN 55311-4548 | 2011-12-26 |
| 1750697587 | Megan Horwitz Plumstead | Psychologist | 1619 Dayton Ave Ste 327, Saint Paul, MN 55104-6495 | 2010-08-31 |
| 1073826913 | Scott Michael Jacoby | Psychologist | 2110 Lyndale Ave S, Minneapolis, MN 55405-3196 | 2010-07-20 |
| Find all providers with the same taxonomy | ||||
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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.