CRYSTAL NACHE CLARK (NPI# 1952677700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952677700 |
| Entity Type | Individual |
| Full Name | CRYSTAL NACHE CLARK |
| Credential | LMHC |
| Practice Address |
13902 Sage Thrasher Lane Riverview FL 33579 |
| Mailing Address |
13194 Us Highway 301 S Ste 144 Riverview FL 33578-7410 |
| Practice Telephone | 8139440151 |
| Mailing Telephone | 8139440151 |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2020-06-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH16603 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5707 N 22nd St, Tampa, FL 336104350 | 8132398069 | 8132723766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581311 | Crystal Clark | Massage Therapist | 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 | 2020-09-01 |
| 1366068470 | Crystal Sherase Clark | Technician | 4429 Grant St Ne, Washington, DC 20019-4739 | 2020-06-24 |
| 1467014894 | Crystal Clark | Chore Provider | 153 Brambury Dr Apt D, Rochester, NY 14621-1820 | 2019-07-06 |
| 1386112050 | Crystal Lynn Clark | Internal Medicine | 12056 224th St, Cambria Heights, NY 11411-2141 | 2018-11-11 |
| 1154898179 | Crystal B Clark | Family Medicine | 112 Woodland Drive, Lancaster, SC 29720 | 2018-10-29 |
| 1801259619 | Crystal Clark | Technician, Other | 3400 State St # 750, Salem, OR 97301-5861 | 2016-03-30 |
| 1467829911 | Crystal Lynn Clark | Specialist/Technologist | 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 | 2015-08-31 |
| 1386073070 | Crystal Shawn Clark | Nurse Anesthetist, Certified Registered | 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 | 2013-11-04 |
| 1417391160 | Crystal Joan Clark | Nurse Practitioner | 11930 Arbor St Ste 200, Omaha, NE 68144-2998 | 2013-04-24 |
| 1639443658 | Crystal A Clark | Chore Provider | 331 Jamestown Ct, Columbus, OH 43228-4030 | 2012-03-08 |
| Street Address |
13902 SAGE THRASHER LANE |
| City | RIVERVIEW |
| State | FL |
| Zip Code | 33579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851912505 | Joanna Johnson | Developmental Therapist | 10910 Keys Gate Drive, Riverview, FL 33579 | 2020-05-05 |
| 1255815114 | Advanced Dental Care of Riverview Pllc | Clinic/Center | 13018 S Us Highway 301, Riverview, FL 33579 | 2018-09-18 |
| 1265920078 | Takashi Dixon | Dentist | 10625 Big Bend Rd, Riverview, FL 33579 | 2018-04-26 |
| 1821513243 | Marie Evens Murat | Registered Nurse | 12718 Lovers Lane, Riverview, FL 33579 | 2017-08-07 |
| 1467907857 | Dorothy Araujo | Assisted Living Facility | 11626 Tropical Isle Ln, Riverview, FL 33579 | 2016-08-16 |
| 1134571128 | Tampa Institute for Pain and Spine, LLC | Anesthesiology | 13140 Elk Mountain Dr, Suite B, Riverview, FL 33579 | 2016-07-01 |
| 1669832242 | Shawn Mckeag | Speech-Language Pathologist | 11838 Newberry Grove Loop, Riverview, FL 33579 | 2016-02-25 |
| 1902202377 | Jose Gerena | Adult Companion | 11325 Village Brook Dr, Riverview, FL 33579 | 2014-11-13 |
| 1912259409 | Brandi L Torres | Nurse Practitioner | 10729 Queens Town Drive, Riverview, FL 33579 | 2012-10-08 |
| 1922339787 | Fermina Liza Roman | Counselor | 11327 Village Brook Drive, Riverview, FL 33579 | 2010-01-19 |
| Find all providers in zip 33579 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487261830 | Angela E. Franklin | Counselor | 12760 Lexington Ridge St, Riverview, FL 33578-7646 | 2020-09-29 |
| 1720618440 | The Pepin Academies, Inc | Counselor | 9304 Camden Field Pkwy, Riverview, FL 33578-0520 | 2020-01-22 |
| 1790328144 | Lydia Angelica Antonatos | Counselor | 12936 Utopia Gardens Way, Riverview, FL 33579-7060 | 2019-10-17 |
| 1053887521 | Natasha Dickens | Counselor | 5523 Legacy Crescent Place, Unit 204, Riverview, FL 33578 | 2018-10-22 |
| 1720596356 | Clarissa Davis | Counselor | 11373 Cocoa Beach Dr, Riverview, FL 33569-2951 | 2018-01-17 |
| 1558807172 | David Speicher | Counselor | 11015 Scott Loop, Riverview, FL 33569-5181 | 2017-01-07 |
| 1073967501 | Gayle Billingsley | Counselor | 6338 Us 301 S, Riverview, FL 33578-3829 | 2016-04-21 |
| 1861873200 | Raquel M Massaro | Counselor | 10013 Water Works Lane, Riverview, FL 33578 | 2015-06-11 |
| 1730569534 | Ginelle Moore | Counselor | 6020 Portsdale Pl Unit 102, Riverview, FL 33578-4156 | 2015-06-05 |
| 1477949055 | Sharon Mckay | Counselor | 10708 Keys Gate Dr, Riverview, FL 33579-4049 | 2015-04-10 |
| Find all providers in RIVERVIEW | ||||
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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.