MARLA JO CLANCY


Address: 3300 Academy Ave, Portsmouth, VA 23703-3205
Phone: 7574836404

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 3300 ACADEMY AVE
City PORTSMOUTH
State VA
Zip Code 23703-3205

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City PORTSMOUTH
Zip Code 23703

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Dataset Information

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.

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