MARLA JO CLANCY (NPI# 1023623436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023623436 |
Entity Type | Individual |
Full Name | MARLA JO CLANCY |
Credential | PMHNP-BC |
Practice Address |
3300 Academy Ave Portsmouth VA 23703-3205 |
Mailing Address |
307 Brightwood Ave Hampton VA 23661-1612 |
Practice Telephone | 7574836404 |
Enumeration Date | 2020-09-11 |
Last Update Date | 2020-09-11 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
0024180099 | VA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3300 ACADEMY AVE |
City | PORTSMOUTH |
State | VA |
Zip Code | 23703-3205 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104819234 | Velma A Bacak | Psychiatry & Neurology | 3300 Academy Ave, Academy Crossing Medical Plaza, Portsmouth, VA 23703-3205 | 2005-08-24 |
1598219214 | Angel Marie Williams-kent | Nurse Practitioner | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2016-08-10 |
1124473038 | Richardean Benjamin | Nurse Practitioner | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2016-04-28 |
1700208873 | Stacie Adrienne Wilson | Psychologist | 3300 Academy Ave, Churchland Psychiatric Associates, Portsmouth, VA 23703-3205 | 2014-01-09 |
1821421454 | Riverside Physician Services Inc | Psychologist | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2013-08-19 |
1568715613 | Melissa Gilbert Gomes | Nurse Practitioner | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2012-10-25 |
1558687954 | Tiffany Davis | Nurse Practitioner | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2010-04-12 |
1578728820 | Eileen P Pietila | Counselor | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2008-07-26 |
1760412183 | Lana Tucker Williams | Counselor | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2006-07-03 |
1821032079 | Martha A Jones | Nurse Practitioner | 3300 Academy Ave, Portsmouth, VA 23703-3205 | 2006-06-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174037444 | Kelly Foster | Massage Therapist | 3108 Tyre Neck Rd Ste D, Portsmouth, VA 23703 | 2017-11-25 |
1578072104 | Katherine Armstrong Wise | Behavior Technician | 3120 Verne Ave, Portsmouth, VA 23703 | 2017-09-27 |
1891223913 | Ashley Rebecca Anderson | Dentist | 5915 High Street W, Portsmouth, VA 23703 | 2017-06-02 |
1881126019 | Anas Elmahdi | Specialist | 5205 Sweetbriar C., 5205 Sweetbriar C., Portsmouth, VA 23703 | 2017-03-28 |
1578003554 | Elyse Buttery | Nurse Practitioner | Mast One 1040 University Blvd, Suite 200, Portsmouth, VA 23703 | 2017-02-24 |
1376948349 | Charles Douglas Knight | Military Health Care Provider | Uss Maryland Ssbn 738, Fpo, AA 23703 | 2014-11-03 |
1689929382 | Positive Connections, Inc | Community/Behavioral Health | 3823d Meherrin River Reach, Portsmouth, VA 23703 | 2012-07-18 |
1225319874 | Sanaz Namin | Pharmacist | 5601 High Street, Porstmouth, VA 23703 | 2011-09-08 |
1295029767 | Maggie Jackson | Dental Hygienist | 4000 Coast Guard Blvd., Portsmouth, VA 23703 | 2011-06-02 |
1679804892 | Amy Kathleenn Gaspar | Specialist/Technologist, Other | 4113 Pendleton Rd, Portsmouth, VA 23703 | 2010-01-28 |
Find all providers in zip 23703 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477178218 | Peace of Mind Therapeutic Solutions, LLC | Nurse Practitioner | 355 Crawford St Ste 102, Portsmouth, VA 23704-2817 | 2020-06-08 |
1467909077 | Patricia Hicks Smith | Nurse Practitioner | 620 John Paul Jones Blvd., Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-09-01 |
1700116563 | Rachel Ryan Baudek | Nurse Practitioner | 620 John Paul Jones Cir Bldg 1226b, Portsmouth, VA 23708-2111 | 2009-12-30 |
1871622993 | Ellen F. Kingsbury | Nurse Practitioner | 100 Shattuck Way Ste 200, Portsmouth, NH 03801-8004 | 2007-03-05 |
1336241983 | Helen S. Rizza | Nurse Practitioner | 30 Mirona Road Ext, Suite 3, Portsmouth, NH 03801-5343 | 2006-09-03 |
1396373205 | Crystal Gayle Mcbee | Nurse Practitioner | 1634 11th St, Portsmouth, OH 45662-4526 | 2020-03-28 |
1265067789 | Donna Marie Hedberg | Nurse Practitioner | 1145 Sagamore Ave, Portsmouth, NH 03801-5585 | 2020-03-04 |
1528610698 | Afaribea Fosu | Nurse Practitioner | 301 Fort Ln, Portsmouth, VA 23704-2221 | 2019-07-09 |
1730674375 | Belinda S Rose | Nurse Practitioner | 1634 11th St, Portsmouth, OH 45662 | 2018-06-26 |
1790231660 | Shauna Nancy Sedler | Nurse Practitioner | 330 Borthwick Ave, Suite 111, Portsmouth, NH 03801-4174 | 2016-08-30 |
Find all providers in PORTSMOUTH |
City | PORTSMOUTH |
Zip Code | 23703 |
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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.