CONNIE CLARK (NPI# 1528489002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528489002 |
| Entity Type | Individual |
| Full Name | CONNIE CLARK |
| Practice Address |
620 Wellhouse Dr Jacksonville FL 32220-1367 |
| Practice Telephone | 9042221784 |
| Practice Fax Number | 9042533001 |
| Mailing Telephone | 9042221784 |
| Mailing Fax Number | 9042533001 |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023500907 | Connie Clark | Physical Therapist | 19280 Indian Summer Ln, Monument, CO 80132-9433 | 2018-06-05 |
| 1205913191 | Connie Lynn Clark | Counselor | 955 S Durkin Dr, Ste. B, Springfield, IL 62704-1370 | 2006-11-01 |
| 1679907513 | Connie Renea Clark | Licensed Practical Nurse | 2410 Charlotte Ave, Nashville, TN 37203-1517 | 2013-08-28 |
| 1942572698 | Connie Clark | Counselor | 2230 Boyd Rd, Murrysville, PA 15632-8997 | 2012-01-26 |
| 1336303106 | Connie Ruth Clark | Nurse Practitioner | 710 Sw Rock Creek Dr, Stevenson, WA 98648-4418 | 2008-07-10 |
| Street Address |
620 WELLHOUSE DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32220-1367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679972665 | Marietta Dental Group | Dentist | 8209 W. Beaver St., Suite 100, Jacksonville, FL 32220 | 2014-08-15 |
| 1689631962 | Nicholas A Narducci | Dentist | 8209 W. Beaver Street, Suite 100, Jacksonville, FL 32220 | 2006-04-28 |
| 1649267857 | Kci Usa, Inc. | Durable Medical Equipment & Medical Supplies | 7029 Commonwealth Ave., Suite 2, Jacksonville, FL 32220 | 2005-10-03 |
| 1710356332 | Heavenly Angels Homemaker & Companion Services | In Home Supportive Care | 9695 Watershed Dr S, Jacksonville, FL 32220-0903 | 2015-09-24 |
| 1487138798 | Tiffany Mosley | Counselor | 9616 Watershed Dr E, Jacksonville, FL 32220-0905 | 2018-09-21 |
| 1861976003 | Earthly Stars, LLC | Home Health | 9616 Watershed Dr E, Jacksonville, FL 32220-0905 | 2018-09-24 |
| 1659848539 | Shanthalitta Seals Wallace | Counselor | 9617 Watershed Dr E, Jacksonville, FL 32220-0906 | 2018-10-29 |
| 1447306246 | Cynthia Jean Paulk | Speech-Language Pathologist | 9826 Watershed Dr W, Jacksonville, FL 32220-0911 | 2007-01-25 |
| 1497809644 | Tzipora S Johnson | Registered Nurse | 10278 Wellhouse Ct, Jacksonville, FL 32220-1351 | 2007-01-23 |
| 1699277699 | Rgh Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 12075 Pritchard Rd, Jacksonville, FL 32220-1777 | 2018-03-06 |
| Find all providers in zip 32220 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720519 | Ashley Harms | Counselor | 4070 Herschel St Ste 1, Jacksonville, FL 32210-2239 | 2020-11-03 |
| 1902418684 | Molly Ann Burkhardt | Counselor | 5776 Saint Augustine Rd # 8030, Jacksonville, FL 32207-8046 | 2020-08-23 |
| 1194335638 | Aiteria Green | Counselor | 9713 Bridgeway Ave, Jacksonville, FL 32222-2913 | 2020-08-07 |
| 1053920116 | Barbara Burden | Counselor | 209 N Carole Dr, Jacksonville, NC 28546-4845 | 2020-07-24 |
| 1790393973 | Kelley Holladay | Counselor | 1782 Plantation Oaks Dr, Jacksonville, FL 32223-5010 | 2020-07-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1447877709 | Quendria Johnson-kerns | Counselor | 200 Zonnie Ln, Jacksonville, NC 28540-9729 | 2020-07-02 |
| 1467077164 | Shanna Horan | Counselor | 13500 Sutton Park Dr S Ste 702, Jacksonville, FL 32224-5290 | 2020-06-09 |
| 1720602527 | Shannon E Raikes | Counselor | 13990 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5543 | 2020-06-08 |
| 1750905253 | Kathlena N Reed | Counselor | 4131 University Blvd S Fl 32216, Jacksonville, FL 32216-4326 | 2020-06-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32220 |
Please comment or provide details below to improve the information on CONNIE 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.