CLIFFORD JOVAN CLARK (NPI# 1649711615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649711615 |
| Entity Type | Individual |
| Full Name | CLIFFORD JOVAN CLARK |
| Credential | LLMSW |
| Practice Address |
44070 W 12 Mile Rd Suite 200 Novi MI 48377-2648 |
| Practice Telephone | 2487738440 |
| Practice Fax Number | 2487738441 |
| Mailing Telephone | 2487738440 |
| Mailing Fax Number | 2487738441 |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2017-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
6801100714 | MI | Behavioral Health & Social Service Providers |
| N | 101YP1600X |
Counselor Specialization: Pastoral |
6801100714 | MI | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
6801100714 | MI | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
6801100714 | MI | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | 6801100714 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952868879 | Clifford Lloyd Clark Jr. | Occupational Therapy Assistant | 501 Esseola Drive, Saluda, NC 28773 | 2019-02-27 |
| 1497872246 | Clifford Lee Clark | Social Worker | 2140 E Ellsworth Rd, Ann Arbor, MI 48108-2552 | 2007-03-26 |
| 1770666729 | Clifford P Clark IIi | Plastic Surgery | 701 W Morse Blvd, Winter Park, FL 32789-3731 | 2006-10-23 |
| 1881612653 | Clifford D Clark | Orthopaedic Surgery | 2500 E Prospect Rd, Fort Collins, CO 80525-9718 | 2006-07-18 |
| 1497712434 | Clifford R Clark | Internal Medicine | 5920 Mcintyre St, Golden, CO 80403-7445 | 2006-04-26 |
| Street Address |
44070 W 12 MILE RD SUITE 200 |
| City | NOVI |
| State | MI |
| Zip Code | 48377-2648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366981524 | Desiree Balconi | Counselor | 44070 W 12 Mile Rd, Suite #200, Novi, MI 48377-2648 | 2017-02-20 |
| 1558800631 | Lyn Spence | Counselor | 44070 W 12 Mile Rd, Suite 200, Novi, MI 48377-2648 | 2017-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679075758 | Andrea Campbell | Nurse Practitioner | 44000 W 12 Mile Rd Ste 113, Novi, MI 48377 | 2018-03-05 |
| 1811421928 | Michigan Eye and Contact Lens Pllc | Optometrist | 42081 14 Mile Road, Novi, MI 48377 | 2017-04-14 |
| 1336695691 | Deanna Lynne Klein | Speech-Language Pathologist | 44140 Fox Run Road, Novi, MI 48377 | 2016-08-28 |
| 1871940973 | Jaime Durante | Nurse Practitioner | 44070 W. 12 Mile Rd, Suite 100, Novi, MI 48377 | 2016-05-18 |
| 1508225624 | Trilogy Healthcare of Oakland II, LLC | Skilled Nursing Facility | 41795 W 12 Mile Road, Novi, MI 48377 | 2016-02-17 |
| 1144688854 | Hussein Azzam | Allergy & Immunology | 46325 W 12 Mile Rd Ste 215, Novi, MI 48377 | 2016-02-09 |
| 1598120164 | Nova Counseling Services Inc. | Counselor | 41650 Clemens Circle, Novi, MI 48377 | 2015-12-23 |
| 1891174587 | Reem Mariam Mansour | Occupational Therapist | 44125 West 12 Mile Rd E-123, Novi, MI 48377 | 2015-05-27 |
| 1154747095 | Ali Hassan Ismail | Dentist | 41920 Wolfe Pass, Novi, MI 48377 | 2014-03-17 |
| 1558703876 | Twelve Oaks Orthodontics Pllc | Dentist | 44110 W 12 Mile Rd, Suite 100, Novi, MI 48377 | 2013-07-29 |
| Find all providers in zip 48377 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548731201 | Brittany Gaddis | Marriage & Family Therapist | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-12-06 |
| 1528549458 | Cinnamin Warren | Marriage & Family Therapist | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-08-28 |
| 1043594781 | Nadia Marie Bazzy | Marriage & Family Therapist | 43155 Main St, Suite 2210d, Novi, MI 48375-1777 | 2011-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588520 | Janice Marie Twesten | Marriage & Family Therapist | 7066 Country Springs Dr Sw, Byron Center, MI 49315-8129 | 2020-11-06 |
| 1891392288 | Megan E Six | Marriage & Family Therapist | 733 Madison Ave Se, Grand Rapids, MI 49503-5317 | 2020-10-08 |
| 1053927350 | Sally Catherine Demshur | Marriage & Family Therapist | 2534 Lupine Ct, Okemos, MI 48864-3366 | 2020-09-22 |
| 1801407481 | Regina V. Grujovski | Marriage & Family Therapist | 25156 Pine View Ave, Warren, MI 48091-1567 | 2020-08-16 |
| 1649892548 | Angie L Nelson-gates | Marriage & Family Therapist | 25 Centennial Ave Nw, Grand Rapids, MI 49504-5921 | 2020-05-13 |
| 1699307512 | James Glen Clapper | Marriage & Family Therapist | 5851 Gilman St, Garden City, MI 48135-2512 | 2020-02-08 |
| 1801427323 | Relationship Therapy LLC | Marriage & Family Therapist | 1800 N Milford Rd Ste 101, Milford, MI 48381-1047 | 2020-02-03 |
| 1508409715 | Susan Lesley King Roney | Marriage & Family Therapist | 934 Cambridge Dr Se, Grand Rapids, MI 49506-3360 | 2019-10-21 |
| 1114575610 | Kymberly M Cunningham | Marriage & Family Therapist | 20220 Mitchell St, Detroit, MI 48234-1577 | 2019-08-28 |
| 1528616224 | Edythe Annette Brown | Marriage & Family Therapist | 26861 Bloomfield Dr S, Lathrup Village, MI 48076-4403 | 2019-08-27 |
| 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.