THERESA L CLARK (NPI# 1104015155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104015155 |
| Entity Type | Individual |
| Full Name | THERESA L CLARK |
| Credential | M.D. |
| Practice Address |
777 Bannock St Denver CO 80204-4507 |
| Mailing Address |
Po Box 1629 Dillon CO 80435-1629 |
| Practice Telephone | 3034363000 |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2019-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
35.135479 | OH | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
DR.0061413 | CO | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME104695 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | TRN11797 | FL | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 7th Ave N, St Petersburg, FL 337051300 | 7278251041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588118665 | Theresa Clark | Licensed Practical Nurse | 6541 Furnace Rd, Ontario, NY 14519-9701 | 2016-08-07 |
| 1003056383 | Theresa Carlisle Clark | Registered Nurse | 1900 Carriage Dr, Phenix City, AL 36867-2116 | 2009-02-26 |
| 1548441710 | Theresa M. Clark | Marriage & Family Therapist | 5 Colony Street, Suites 301/303, Meriden, CT 06451-3272 | 2007-11-16 |
| 1972700912 | Theresa Marie Clark | Counselor | 108 E 12th St, Suite 1, Hays, KS 67601-3668 | 2007-07-02 |
| 1013120948 | Theresa S. Clark | Dietitian, Registered | 530 Noel Ave, Hopkinsville, KY 42240-1386 | 2007-05-07 |
| 1548893506 | Theresa Ann Clark | Nurse Practitioner | 420 N Main St, Middlebury, IN 46540-8985 | 2020-02-18 |
| 1457688384 | Theresa Clark | Marriage & Family Therapist | 1800 Gravenstein Hwy N, Sebastopol, CA 95472-2607 | 2009-11-13 |
| 1104079839 | Theresa Clark | Registered Nurse | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2008-10-26 |
| 1659520799 | Theresa Clark | Occupational Therapy Assistant | 2300 Great Lakes Dr, Dyer, IN 46311-1917 | 2008-09-12 |
| 1528104650 | Theresa Ross Clark | Internal Medicine | 2067 W Vista Way, Suite 200, Vista, CA 92083-6031 | 2007-01-29 |
| Street Address |
777 BANNOCK ST |
| City | DENVER |
| State | CO |
| Zip Code | 80204-4507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316941735 | Teresa A Wilcox | Nurse Practitioner | 777 Bannock St, Mc 1914, Denver, CO 80204-4507 | 2005-06-13 |
| 1437765997 | Nekol R Daley | Registered Nurse | 777 Bannock St, Denver, CO 80204-4597 | 2020-09-21 |
| 1386261535 | Ivori Alexandria Zvorsky | Student in an Organized Health Care Education/Training Program | 777 Bannock St, Denver, CO 80204-4507 | 2020-07-02 |
| 1770100166 | Rachel Christina Corey-pacheco | Registered Nurse | 777 Bannock St, Denver, CO 80204-4507 | 2020-07-01 |
| 1205450202 | Jeff Foster | Registered Nurse | 777 Bannock St, Denver, CO 80204-4597 | 2020-06-04 |
| 1558990697 | Alana Byrnes | Registered Nurse | 777 Bannock St, Denver, CO 80204-4597 | 2020-04-01 |
| 1437785862 | Brian James Wang | Physician Assistant | 777 Bannock St, Denver, CO 80204-4507 | 2020-03-17 |
| 1881220648 | Marina Elyse Payne | Registered Nurse | 777 Bannock St, Denver, CO 80204-4507 | 2020-03-12 |
| 1649805649 | Karin Gallup | Registered Nurse | 777 Bannock St, Denver, CO 80204-4507 | 2020-03-10 |
| 1184259178 | Heather Krohn | Registered Nurse | 777 Bannock St, Denver, CO 80204-4597 | 2020-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205483716 | Pam Specialty Hospital of Denver LLC | Long Term Care Hospital | 1690 N Meade St, Denver, CO 80204 | 2019-08-20 |
| 1912468125 | Rachel Vanderwel | Student in an Organized Health Care Education/Training Program | 777 Bancock Street, Mc 0108, Denver, CO 80204 | 2019-03-29 |
| 1831673391 | Alexandra Wilcox | Counselor | 1175 Osage St, Suite 205, Denver, CO 80204 | 2018-09-20 |
| 1912480716 | Arieye, Inc | Ophthalmology | 3120 W 19th Ave, Unit 3, Denver, CO 80204 | 2018-09-08 |
| 1144701053 | Kristina Ann Petrosino | Dental Hygienist | 601 Broadway St., Denver, CO 80204 | 2018-08-28 |
| 1811474075 | Lindsey Spraker | Counselor | 1175 Osage Street, Suite 205, Denver, CO 80204 | 2018-07-20 |
| 1427541887 | Healthy Life Care LLC | Home Health | 500 Newton St, Denver, CO 80204 | 2018-06-11 |
| 1932601655 | Emily Gispert Weaver | Student in an Organized Health Care Education/Training Program | 301 W. 6th Ave., Denver, CO 80204 | 2018-03-08 |
| 1144745928 | Melisssa Wells | Licensed Practical Nurse | 1801 W. 13th Ave, Denver, CO 80204 | 2017-08-14 |
| 1689112948 | Tyler Stephens | Student in an Organized Health Care Education/Training Program | 2233 Champa St., Denver, CO 80204 | 2017-02-07 |
| Find all providers in zip 80204 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786445 | Eating Recovery Center | Psychiatry & Neurology | 8140 E. 5th Ave, Denver, CO 80230 | 2020-09-25 |
| 1023639929 | Lcl Wellness, LLC | Psychiatry & Neurology | 7550 W Yale Ave Ste A155, Denver, CO 80227-3487 | 2020-05-01 |
| 1255838348 | Ketamine Treatment Centers of Denver Pllc | Psychiatry & Neurology | 1355 S Colorado Blvd # C-304, Denver, CO 80222-3305 | 2018-04-06 |
| 1164861670 | John S. Graves, M.d., P.C. | Psychiatry & Neurology | 4770 E Iliff Ave. #228, Denver, CO 80222 | 2013-06-18 |
| 1932544723 | Callie Deann Montez | Psychiatry & Neurology | 425 S Cherry St Ste 620, Denver, CO 80246-1233 | 2013-05-07 |
| 1407113087 | Joshua Andrew Evans | Psychiatry & Neurology | 950 S Cherry St Ste 420, Denver, CO 80246-2664 | 2012-04-19 |
| 1790041143 | Akos Mersich | Psychiatry & Neurology | 4900 E Cherry Creek South Dr Ste E, Denver, CO 80246-2283 | 2012-04-10 |
| 1194098103 | Peter Mayerson | Psychiatry & Neurology | 2000 Little Raven St., #999, Denver, CO 80202-6199 | 2012-02-22 |
| 1699067603 | Cecile Audrey Mauge | Psychiatry & Neurology | 2611 Ivy St, Denver, CO 80207-3414 | 2011-05-09 |
| 1477858280 | Kristi L Cassleman | Psychiatry & Neurology | 7900 E 1st Ave Ste 200, Denver, CO 80230-7204 | 2011-01-26 |
| Find all providers in DENVER | ||||
Please comment or provide details below to improve the information on THERESA L CLARK.
| 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.