DR. JOHNETTE ELISSE CLARK (NPI# 1801963137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801963137 |
| Entity Type | Individual |
| Full Name | DR. JOHNETTE ELISSE CLARK |
| Credential | PH.D. |
| Practice Address |
1301 N 2nd St Atchison KS 66002-1202 |
| Mailing Address |
130 Su Terra Dr Atchison KS 66002-1023 |
| Practice Telephone | 9133671593 |
| Practice Fax Number | 9133671627 |
| Mailing Telephone | 9133672824 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
LP 1021 | KS | Behavioral Health & Social Service Providers |
| Street Address |
1301 N 2ND ST |
| City | ATCHISON |
| State | KS |
| Zip Code | 66002-1202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629308192 | Atchison Hospital Emergency Department | General Acute Care Hospital | 1301 N 2nd St, Atchison, KS 66002-1297 | 2010-01-06 |
| 1801122353 | Atchison Hospital | General Acute Care Hospital | 1301 N 2nd St, Atchison, KS 66002-1297 | 2009-10-19 |
| 1003043308 | Stephen Scott Durkin | Social Worker | 1301 N 2nd St, Atchison, KS 66002-1297 | 2009-06-15 |
| 1164677225 | Shannon Winter | Counselor | 1301 N 2nd St, Atchison, KS 66002-1297 | 2008-11-17 |
| 1790937555 | Karla Brockman | Counselor | 1301 N 2nd St, Atchison, KS 66002-1297 | 2008-10-10 |
| 1639354707 | Jason R Wells | Psychologist | 1301 N 2nd St, Atchison, KS 66002-1297 | 2008-01-08 |
| 1538205786 | Peggy L Libel | Psychologist | 1301 N 2nd St, Atchison, KS 66002-1202 | 2007-01-29 |
| 1821156274 | Janette Rose Miller | Social Worker | 1301 N 2nd St, Atchison, KS 66002-1202 | 2006-12-05 |
| 1184691883 | Kendra Minnick | Social Worker | 1301 N 2nd St, Atchison, KS 66002-1297 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396231312 | Atchison Dental Associates 2 Pa | Dentist | 111 North 5th Street, Atchison, KS 66002 | 2018-07-02 |
| 1730614918 | Marilyn Franck Glenn | Counselor | 107 N. 6th St., Suite #4, Atchison, KS 66002 | 2017-04-26 |
| 1508299108 | Rachel Dawn Gauntt Weaver | Social Worker | 2135 Main Street, Atchison, KS 66002 | 2013-08-19 |
| 1154660520 | Melinda Pregont | Chiropractor | 310 Commercial Street, Atchison, KS 66002 | 2013-02-05 |
| 1265711675 | Atchison Community Health Clinic Inc | Dentist | 1412 North 2nd St., Atchison, KS 66002 | 2011-08-16 |
| 1093031585 | Pamela Jane Rizza | Family Medicine | 810 Ravenhill Drive, Atchison, KS 66002 | 2010-04-09 |
| 1730410002 | Kansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 400 South 10th Street, Atchison, KS 66002 | 2010-01-26 |
| 1679785893 | John M Speckhals | Counselor | 1301 N 2nd Street, Atchison, KS 66002 | 2007-05-03 |
| 1134284680 | County of Atchison | Nursing Care | 1419 North 6th, Atchison, KS 66002 | 2006-12-26 |
| 1437218351 | Mandy Kay Uhler | Psychologist | 1301 N 2nd, Atchison, KS 66002 | 2006-12-06 |
| Find all providers in zip 66002 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174097133 | Janine Kesterson-cravens | Psychologist | 8100 E 22nd St N # 1600, Wichita, KS 67226-2388 | 2019-01-14 |
| 1073978979 | Kari Struemph | Psychologist | 2106 Olathe Blvd Mailstop 4004, Kansas City, KS 66160-0001 | 2015-12-18 |
| 1568655637 | Deidra Mcgie Johnson | Psychologist | 1102 S. Rouse, Pittsburg, KS 66762 | 2007-08-22 |
| 1225220858 | Leticia Ann Holub Taylor | Psychologist | 515 N Mur Len Rd, Olathe, KS 66062-1267 | 2007-08-17 |
| 1760674808 | Eric Morrison Vernberg | Psychologist | 1000 Sunnyside Ave, Clinical Child Psychology Program, Lawrence, KS 66045-7555 | 2007-08-13 |
| 1649476094 | Stephen Robert Lassen | Psychologist | 3901 Rainbow Blvd # Ms -4004, Kansas City, KS 66160-0001 | 2007-06-22 |
| 1710033642 | Charles Anthony Krall | Psychologist | 426 W 14th St, Chanute, KS 66720-2878 | 2007-01-25 |
| 1952453573 | Nathan A Fawson | Psychologist | 304 N Jefferson, Iola, KS 66749 | 2007-01-16 |
| 1902465701 | Alison Kathleen Calkins-smith | Psychologist | 8800 W 75th St Ste 220, Shawnee Mission, KS 66204-4001 | 2019-06-06 |
| 1902306640 | Amy E Noser | Psychologist | 200 Maine St Ste A, Lawrence, KS 66044-1396 | 2018-02-20 |
| 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.