JACQUELINE RENEE CLARK (NPI# 1548452956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548452956 |
| Entity Type | Individual |
| Full Name | JACQUELINE RENEE CLARK |
| Credential | BA, HRC |
| Practice Address |
118 E Main St Holdenville OK 74848-3208 |
| Mailing Address |
17964 County Road 1500 Ada OK 74820-4717 |
| Practice Telephone | 4053795256 |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2007-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720594955 | Jacqueline Clark | Behavior Technician | 10530 Warwick Ave Ste C2, Fairfax, VA 22030-3132 | 2017-12-26 |
| 1336552629 | Jacqueline Clark | Specialist/Technologist | 550 Huntington Ave, Boston, MA 02115-5901 | 2014-06-04 |
| 1497015762 | Jacqueline Clark | Counselor | 923 Powell Ave Sw, Suite 100, Renton, WA 98057-2941 | 2012-05-21 |
| 1407008287 | Jacqueline Ruth Clark | Licensed Practical Nurse | 26308 Crocker Rd, Columbia Station, OH 44028-9301 | 2008-10-13 |
| 1902424161 | Jacqueline E Clark | Advanced Practice Midwife | 1021 Nebraska St, Sioux City, IA 51105-1436 | 2020-07-13 |
| 1205456795 | Jacqueline Clark | Behavior Technician | 182 El Dorado St, Monterey, CA 93940-3118 | 2020-04-24 |
| 1982175493 | Jacqueline Clark | Occupational Therapist | 888 Terrace St, Muskegon, MI 49440-1220 | 2018-12-10 |
| 1194244749 | Jacqueline Ann Clark | Counselor | 811 Madison St, Everett, WA 98203-4543 | 2017-09-14 |
| 1215452958 | Jacqueline Clark | Physical Therapist | 546 E Sandy Lake Rd Ste 110, Coppell, TX 75019-5787 | 2017-08-03 |
| 1245578343 | Jacqueline Anne Clark | Counselor | 2845 Bell St, Zanesville, OH 43701-1720 | 2013-01-24 |
| Street Address |
118 E MAIN ST |
| City | HOLDENVILLE |
| State | OK |
| Zip Code | 74848-3208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306314133 | Shelley Byrd | Peer Specialist | 118 E Main St, Holdenville, OK 74848-3208 | 2018-11-09 |
| 1619444775 | Ashleigh Louise Halterman | Case Manager/Care Coordinator | 118 E Main St, Holdenville, OK 74848-3208 | 2018-10-26 |
| 1043420227 | Itha Joyce Gray | Counselor | 118 E Main St, Holdenville, OK 74848-3208 | 2007-05-23 |
| 1235217217 | Oklahoma Families First Inc | Clinic/Center | 118 E Main St, Holdenville, OK 74848-3208 | 2006-11-01 |
| 1396847257 | Oklahoma Families First Inc | Clinic/Center | 118 E Main St, Holdenville, OK 74848-3208 | 2006-09-02 |
| 1588607436 | Judith A. Robinson | Social Worker | 118 E Main St, Holdenville, OK 74848-3208 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790276160 | Corner Clinic Aprn-cnp Pllc | Clinic/Center | 201 N Hinkley, Holdenville, OH 74848 | 2018-05-22 |
| 1063948230 | Savannah Ione Hartwick | Personal Emergency Response Attendant | 400 Crestview Dr., Holdenville, OK 74848 | 2017-05-10 |
| 1568910297 | Alicia Rose Gosey | Nurse Practitioner | 1011 N Hinkley St, Holdenville, OK 74848 | 2016-09-11 |
| 1649611278 | Sooner Health Services IIi, Inc. | Home Health | 106 N Broadway, Holdenville, OK 74848 | 2013-07-11 |
| 1275852089 | Jennifer Michele Gaines | Counselor | 117 Rogers Drive, Holdenville, OK 74848 | 2010-05-19 |
| 1497975528 | Gloria Buenrostro Turner | Physical Therapist | Therapy Care Outpatient PC, 317 E 8th St, Holdenville, OK 74848 | 2007-04-30 |
| 1215075528 | Therapy Care Outpatient PC | Physical Therapist | 317 E 8th Street, Holdenville, OK 74848 | 2007-02-01 |
| 1285724732 | Heritage Village Nursing Center, LLC | Skilled Nursing Facility | 801 Highway #48, Holdenville, OK 74848 | 2006-10-13 |
| 1861484776 | Joseph Omer Lavalley | Dentist | 300 E Hwy, Holdenville, OK 74848 | 2005-08-17 |
| 1699150052 | Stephanie Keesee | Nurse Practitioner | 201 N Hinckley St, Holdenville, OK 74848 | 2015-07-28 |
| Find all providers in zip 74848 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275852089 | Jennifer Michele Gaines | Counselor | 117 Rogers Drive, Holdenville, OK 74848 | 2010-05-19 |
| 1992143408 | Shaina Moon | Counselor | 117 Rogers Drive, Holdenville, OK 74848 | 2013-06-06 |
| 1881967693 | Olivia Wild-terrill | Counselor | 117 Rogers Drive, Holdenville, OK 74848 | 2012-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039517 | Tommy Craig Smith | Counselor | 3601 N Classen Blvd Ste 102, Oklahoma City, OK 73118-3231 | 2020-09-29 |
| 1881200558 | Nichole Rae Krausch | Counselor | 1507 S Mckenna St, Poteau, OK 74953-5207 | 2020-09-18 |
| 1467068098 | Mckenzie Mcguffee | Counselor | 717 Briarcrest Dr, Midwest City, OK 73110-1619 | 2020-09-18 |
| 1629683727 | Mason Counseling Services | Counselor | 12718 E 77th Pl N, Owasso, OK 74055-7938 | 2020-09-15 |
| 1437761004 | Ashley Jane Runnells | Counselor | 4867 S Sheridan Rd Ste 712a, Tulsa, OK 74145-5721 | 2020-08-17 |
| 1982214292 | Tera Dee Robbins | Counselor | 1002 Cambell Street, Warner, OK 74469 | 2020-08-03 |
| 1619587946 | Chelsey S Kopaddy | Counselor | 1108 Nw Elm Ave, Lawton, OK 73507-4607 | 2020-08-02 |
| 1932718376 | David Louis Holden | Counselor | 1803 W Wood Drive, Okmulgee, OK 74447 | 2020-07-30 |
| 1043829278 | Tracy Nanette Mckeown | Counselor | 1777 S Yukon Pkwy, Yukon, OK 73099-4599 | 2020-07-23 |
| 1063039915 | Sarah Nicole Hawthorne | Counselor | 12834 S Old Highway 169, Oologah, OK 74053-3333 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | HOLDENVILLE |
| Zip Code | 74848 |
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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.