MRS. CARMEN MICHELLE CLARK (NPI# 1124463450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124463450 |
| Entity Type | Individual |
| Full Name | MRS. CARMEN MICHELLE CLARK |
| Practice Address |
7302 Meadow Rd Crestwood KY 40014-9453 |
| Practice Telephone | 5022415159 |
| Mailing Telephone | 5022415159 |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2013-04-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | KY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154523652 | Carmen Elena Clark | Specialist | 324 Edgewood Ave, Teaneck, NJ 07666-3021 | 2007-06-05 |
| 1245254986 | Carmen Beth Clark | Speech-Language Pathologist | 29 N Academy St, Greenville, SC 29601-2629 | 2006-07-26 |
| Street Address |
7302 MEADOW RD |
| City | CRESTWOOD |
| State | KY |
| Zip Code | 40014-9453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720411556 | Meagan L Vowels | Behavioral Analyst | 5895 W. Hwy 146, Crestwood, KY 40014 | 2013-08-15 |
| 1003157538 | Craig L Satterley | Physical Therapist | 6003 Pleasant Colony Ct Ste 3, Crestwood, KY 40014 | 2013-03-07 |
| 1871868802 | Wallace Lyle Past Sr. | General Practice | 4608 Heritage Manor, Crestwood, KY 40014 | 2012-03-08 |
| 1609153725 | Patricia Ann Gray | Behavioral Analyst | 5895 W Highway 146, Crestwood, KY 40014 | 2011-11-03 |
| 1528374253 | Laura R Carroll | Dentist | 6344 W. Hwy 146 Ste 100, Crestwood, KY 40014 | 2010-08-18 |
| 1699922849 | Mortenson Family Dental Center | Clinic/Center | 6408 W Hwy 146, Crestwood, KY 40014 | 2008-08-19 |
| 1760658546 | Kathy J. Pansegrau, Dc, Psc | Chiropractor | 6402 Westwind Way, Suite 5, Crestwood, KY 40014 | 2008-05-01 |
| 1952584054 | Alyssa Ann Dykgraaf | Dentist | 5805 Whwy 22, Ste 100, Crestwood, KY 40014 | 2007-12-11 |
| 1780881649 | Gwinn A. K. Vonnahme | Dentist | 5998 Pleasant Colony Ct. Suite 23, Crestwood, KY 40014 | 2007-07-02 |
| 1326250960 | Sue B Feeley | Dentist | 6225 W Hwy 146, Crestwood, KY 40014 | 2007-05-04 |
| Find all providers in zip 40014 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417214248 | Elizabeth Anne Ray | Developmental Therapist | 7200 Pryor Ave, Crestwood, KY 40014-9315 | 2012-04-18 |
| 1720252703 | Amber N Guzak | Developmental Therapist | 4255 142nd St, Crestwood, IL 60445-2307 | 2008-04-21 |
| 1326519893 | Hannah Kathryn Graham | Developmental Therapist | 6317 Highway 329, Crestwood, KY 40014-9040 | 2018-12-10 |
| 1295182319 | Elisabeth Anne Williams | Developmental Therapist | 6317 Highway 329, Crestwood, KY 40014-9040 | 2016-05-18 |
| 1821304270 | Shannon Pawul | Developmental Therapist | 6317 Highway 329, Crestwood, KY 40014-9040 | 2010-08-24 |
| 1417186370 | Angela Grace Smith | Developmental Therapist | 6317 Highway 329, Crestwood, KY 40014-9040 | 2009-07-13 |
| 1225293236 | Winifred Mallory Turner | Developmental Therapist | 6317 Highway 329, Crestwood, KY 40014-9040 | 2008-07-20 |
| 1316135668 | Brooke Michelle Raque Rohrs | Developmental Therapist | 6317 Highway 329, Crestwood, KY 40014-9040 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073142790 | Andrea Williams | Developmental Therapist | 50 Faith Ct Apt 12, Somerset, KY 42503-5887 | 2020-04-04 |
| 1396379194 | Lori Allen | Developmental Therapist | 717 Carolyn St, Radcliff, KY 40160-1719 | 2020-03-02 |
| 1982237798 | Nicole Teann Fossier | Developmental Therapist | 220 Blake Way, Mt. Sterling, KY 40353 | 2020-02-20 |
| 1669002598 | Darlene King | Developmental Therapist | 11314 Breeze Cir Unit 203, Louisville, KY 40272-4570 | 2020-01-20 |
| 1194365494 | Ruthann Smith | Developmental Therapist | 398 Rebecca Ann Ct, Elizabethtown, KY 42701-4333 | 2020-01-14 |
| 1437799301 | Lauren Hughes | Developmental Therapist | 4736 Sardis Rd, Mount Olivet, KY 41064-7636 | 2020-01-08 |
| 1336788306 | Hillary Brown | Developmental Therapist | 150 Hickory Dr, Madisonville, KY 42431-5843 | 2019-12-23 |
| 1730727330 | Megan Cantrell | Developmental Therapist | 6441 South Hwy, Salt Lick, KY 40371 | 2019-12-13 |
| 1417595059 | Lauren Ashley Creech | Developmental Therapist | 5617 Chestnutwood Way, Louisville, KY 40272-5007 | 2019-12-13 |
| 1285272039 | Beth Mccord | Developmental Therapist | 5028 Main St, Mayslick, KY 41055-8725 | 2019-12-11 |
| Find all providers with the same taxonomy | ||||
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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.