JENNIFER K CLARK (NPI# 1992088611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992088611 |
| Entity Type | Individual |
| Full Name | JENNIFER K CLARK |
| Credential | PH.D. |
| Practice Address |
43130 Amberwood Plz Suite 140 South Riding VA 20152-4105 |
| Practice Telephone | 7035427770 |
| Mailing Telephone | 7035427770 |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810004270 | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723038 | Jennifer Michelle Clark | Social Worker | 22 Norva Ave, Frederick, MD 21701-6279 | 2020-06-04 |
| 1982249926 | Jennifer Rae Clark | Nurse Practitioner | 2800 E League City Pkwy Apt 216, League City, TX 77573-1676 | 2019-11-13 |
| 1528546827 | Jennifer Clark | Technician | 59 Forrester St Sw Apt B, Washington, DC 20032-2120 | 2018-07-30 |
| 1265940340 | Jennifer Anne Clark | Counselor | 35 Pulaski Rd, Whitehouse Station, NJ 08889-3516 | 2018-01-11 |
| 1598118572 | Jennifer Clark | Internal Medicine | 1120 W. Michigan Street Gatch Hall Cl 630, Indianapolis, IN 46204 | 2016-07-14 |
| 1295124899 | Jennifer Clark | Behavioral Analyst | 662 Lake George Dr, Melbourne, FL 32940-2221 | 2015-01-20 |
| 1851707194 | Jennifer Sara Clark | Physical Therapist | 797 Evergreen Dr, West Hempstead, NY 11552-3406 | 2014-07-08 |
| 1083988794 | Jennifer Makiki Clark | Health Educator | 5858 Wilshire Blvd Ste 300, Los Angeles, CA 90036-4509 | 2012-02-27 |
| 1639484520 | Jennifer Ann Clark | Speech-Language Pathologist | 5903 Neptune Dr, Fort Collins, CO 80525-3905 | 2010-08-16 |
| 1245567247 | Jennifer Selleck Clark | Nurse Practitioner | 1840 Martin Luther King Jr Blvd Ste C4, Chapel Hill, NC 27514 | 2009-11-11 |
| Street Address |
43130 AMBERWOOD PLZ SUITE 140 |
| City | SOUTH RIDING |
| State | VA |
| Zip Code | 20152-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508963141 | Janice Lynne Shubert | Social Worker | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2006-09-17 |
| 1902354814 | Chiron Physical Therapy of Va, LLC | Physical Therapist | 43130 Amberwood Plz, Suite 100, South Riding, VA 20152-4105 | 2016-09-20 |
| 1932652666 | Blue Skyy LLC | Physical Therapist | 43130 Amberwood Plz, Suite 100, South Riding, VA 20152-4105 | 2016-07-29 |
| 1013305747 | Casey Leann Davis | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2015-01-05 |
| 1386059988 | Stacey Nicole Lambour | Nurse Practitioner | 43130 Amberwood Plz, 140, South Riding, VA 20152-4105 | 2014-06-23 |
| 1205171790 | Andrea C Mettler Armstrong | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-12-10 |
| 1053665869 | Catherine Lander | Nurse Practitioner | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-10-31 |
| 1376816405 | Courtney Weaver | Social Worker | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-02-21 |
| 1396013173 | Amber L.s. Parker | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2011-12-07 |
| 1891062865 | Damon Marco Saunders | Social Worker | 43130 Amberwood Plz, South Riding, VA 20152-4105 | 2011-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669751 | Joy Chirnside Mclaughlin | Physical Therapist | 26097 Iverson Drive, Chantilly, VA 20152 | 2020-11-04 |
| 1972132090 | Alissa S Rexo | Specialist | 25251 Beach Place, Chantilly, VA 20152 | 2020-04-02 |
| 1982178620 | South Riding Modern Dentistry, PC | Dentist | 25421 Lizzio Center Dr., Suite 190, Chantilly, VA 20152 | 2019-01-16 |
| 1154897627 | Nicole Hong | Dentist | 25273 Nesting Sq, Chantilly, VA 20152 | 2018-10-22 |
| 1437586369 | Chiron Physical Therapy LLC | Physical Therapist | 48130 Amberwood Plaza, Suite 100, South Riding, VA 20152 | 2013-10-10 |
| 1376772178 | Gloria Seon-young Kim | Dentist | 24805 Pinebrook Rd # 311, Chantilly, VA 20152 | 2009-07-14 |
| 1992955777 | Sohaib S. Elsayed | Family Medicine | 25055 Riding Plz Ste 220, South Riding, VA 20152 | 2008-09-29 |
| 1538328067 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 24795 Pinebrook Rd, South Riding, VA 20152 | 2008-06-09 |
| 1790970556 | Irfan Galaria | Plastic Surgery | 24805 Pinebrook Road, Suite #154, Chantilly, VA 20152 | 2007-09-13 |
| 1316150881 | Dina Gottesman | Pediatrics | 25055 Riding Plaza, Suite 150, South Riding, VA 20152 | 2007-05-08 |
| Find all providers in zip 20152 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013305747 | Casey Leann Davis | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2015-01-05 |
| 1205171790 | Andrea C Mettler Armstrong | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2012-12-10 |
| 1396013173 | Amber L.s. Parker | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2011-12-07 |
| 1518268457 | Karena A Wilson-plater | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2010-11-09 |
| 1841503901 | Rachel L Spurrier | Psychologist | 43130 Amberwood Plz, Suite 140, South Riding, VA 20152-4105 | 2010-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593603 | Tina Tehrani Nawaz | Psychologist | 23909 Heather Meadow Dr, Ashburn, VA 20148-1767 | 2020-09-16 |
| 1942813720 | David Rothman | Psychologist | 2000 Wilkes Drive, Richomd, VA 23233 | 2020-08-31 |
| 1174135917 | Elizabeth Dehart Richardson | Psychologist | 3023 Arrowhead Rd, Rockingham, VA 22801-8682 | 2020-08-22 |
| 1558973131 | Saharay Elizabeth Martinez | Psychologist | 26 Zenith Loop, Newport News, VA 23601-1270 | 2020-08-17 |
| 1881204097 | Maria Elena Burke | Psychologist | 108 Colonels Way, Williamsburg, VA 23185-5105 | 2020-08-03 |
| 1699385013 | Celeste Macdonald Kelly | Psychologist | 250 Wylderose Cmns, Midlothian, VA 23113-6883 | 2020-08-01 |
| 1811515794 | Thomas Craig Foster Jr. | Psychologist | 115 Bulifants Blvd Ste A, Williamsburg, VA 23188-5720 | 2020-07-08 |
| 1225655012 | Drew Taylor Bassett | Psychologist | 1970 Roanoke Blvd # 116b1, Salem, VA 24153-6404 | 2020-06-29 |
| 1851917843 | Nathaniel Andrew | Psychologist | 3112 Honeywood Ln Apt E, Roanoke, VA 24018-8853 | 2020-06-25 |
| 1548886674 | Anita L Boss | Psychologist | 1200 Prince St, Alexandria, VA 22314-2936 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH RIDING |
| Zip Code | 20152 |
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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.