MR. JERRY D CLARK (NPI# 1710058284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710058284 |
| Entity Type | Individual |
| Full Name | MR. JERRY D CLARK |
| Credential | LPC |
| Practice Address |
1830 Nasa Pkwy Ste 104 Houston TX 77058-3544 |
| Practice Telephone | 2813358422 |
| Practice Fax Number | 2813350702 |
| Mailing Telephone | 2813358422 |
| Mailing Fax Number | 2813350702 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
15162 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548664766 | Jerry Kent Clark Jr. | Audiologist | 4611 Otter Ct, Burlington, NC 27215-9076 | 2014-10-17 |
| 1447490792 | Jerry W Clark | Counselor | 470 Bannon St, Sacramento, CA 95811-0204 | 2009-02-26 |
| 1114082872 | Jerry S Clark | Chiropractor | 3325 N University Ave Ste 125, Provo, UT 84604-6615 | 2006-12-23 |
| 1639187297 | Jerry Christopher Clark | Massage Therapist | 2360 S Union Ave, Alliance, OH 44601-5079 | 2006-08-03 |
| 1710465919 | Jerry Clark | Behavioral Analyst | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2018-07-31 |
| 1497232060 | Jerry Dean Clark | Counselor | 1616 S Gold St Ste 4, Centralia, WA 98531-8930 | 2018-07-25 |
| 1881911261 | Jerry Lee Clark | Social Worker | 201 W Broadway St, Suite A, North Little Rock, AR 72114-5552 | 2010-04-26 |
| 1619203551 | Jerry R Clark | Dentist | 1115 W Friendly Ave, Greensboro, NC 27401-1844 | 2009-10-28 |
| 1356521371 | Jerry Lee Clark | Counselor | 112 N Broad St, Rm 821, Phila, PA 19102-1510 | 2007-11-07 |
| 1346280005 | Jerry A Clark | Internal Medicine | 722 N Fairfield Rd, Beavercreek, OH 45434-5918 | 2006-06-08 |
| Street Address |
1830 NASA PKWY STE 104 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77058-3544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699248807 | Jolly Joseph | Nurse Practitioner | 18300, Houston Methodist, Houston, TX 77058 | 2019-01-10 |
| 1700372992 | Jasmin Elise Auzenne | Audiologist | 17625 El Camino Real Ste 155, Houston, TX 77058 | 2018-07-10 |
| 1053801225 | Dialyspa Vii LLC | Clinic/Center | 1411 Bonner St., Houston, TX 77058 | 2018-05-14 |
| 1699263285 | Pneucare, LLC | Durable Medical Equipment & Medical Supplies | 1322 Space Park Dr Ste C120, Houston, TX 77058 | 2018-04-29 |
| 1972005189 | Limy Fernandus | Nurse Practitioner | 985 E Nasa Pkwy, Houston, TX 77058 | 2018-03-03 |
| 1033623616 | Sigi Paul | Nurse Practitioner | 1210 El Camino Village Dr., Houston, TX 77058 | 2017-11-19 |
| 1881107845 | Jennifer Elise Hobson | Counselor | 1322 Space Park Dr Ste B123, Houston, TX 77058 | 2017-11-13 |
| 1174035778 | Agrarian Wellness, LLC | Registered Nurse | 17000 El Camino Real Ste 209, Houston, TX 77058 | 2017-11-04 |
| 1013468073 | Cynthia Bandemer | Counselor | 17300 El Camino Real Ste 107d, Houston, TX 77058 | 2016-10-14 |
| 1043698533 | Hopewell Home Healthcare LLC | Nursing Care | 18090 Kings Row, Houston, TX 77058 | 2015-05-15 |
| Find all providers in zip 77058 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749597 | Ebony Jackson | Counselor | 11510 Homestead Rd Ste 295, Houston, TX 77016-1237 | 2020-10-27 |
| 1306445143 | The Journey School of Houston | Counselor | 2025 W 11th St, Houston, TX 77008-6320 | 2020-10-22 |
| 1467059998 | D'jalon J Bell | Counselor | 1255 Eldridge Pkwy Apt 222, Houston, TX 77077-2163 | 2020-10-07 |
| 1770190100 | Amy Senftleber-makopoulos | Counselor | 3131 West Loop S Apt 529, Houston, TX 77027-6138 | 2020-09-29 |
| 1073120788 | Blossom Tree Counseling | Counselor | 14405 Walters Rd Ste 604, Houston, TX 77014-1551 | 2020-09-26 |
| 1174130280 | Candrea Lucas | Counselor | 1755 Crescent Plaza Dr Apt 3036, Houston, TX 77077-5766 | 2020-09-23 |
| 1710592902 | Cassandra Johnson | Counselor | 14318 Alaman Dr, Houston, TX 77090-2488 | 2020-09-14 |
| 1407467616 | Jennifer Aimee Mouille | Counselor | 7815 Capri Cir, Houston, TX 77095-3453 | 2020-08-11 |
| 1477163079 | Liason Conselining Service | Counselor | 5311 Kirby Dr Ste 101, Houston, TX 77005-1315 | 2020-08-07 |
| 1043828999 | Paulette Maureen Edwards | Counselor | 9419 Stonehouse Ln, Houston, TX 77025-4030 | 2020-07-16 |
| Find all providers in HOUSTON | ||||
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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.