MS. CONNIE LYNN CLARK (NPI# 1205913191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205913191 |
| Entity Type | Individual |
| Full Name | MS. CONNIE LYNN CLARK |
| Credential | M.S.ED., LCPC |
| Practice Address |
955 S Durkin Dr Ste. B Springfield IL 62704-1370 |
| Practice Telephone | 2177531288 |
| Mailing Telephone | 2177531288 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-11-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 180.006792 | IL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
180.006792 | IL | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.006792 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023500907 | Connie Clark | Physical Therapist | 19280 Indian Summer Ln, Monument, CO 80132-9433 | 2018-06-05 |
| 1528489002 | Connie Clark | Counselor | 620 Wellhouse Dr, Jacksonville, FL 32220-1367 | 2013-12-30 |
| 1679907513 | Connie Renea Clark | Licensed Practical Nurse | 2410 Charlotte Ave, Nashville, TN 37203-1517 | 2013-08-28 |
| 1942572698 | Connie Clark | Counselor | 2230 Boyd Rd, Murrysville, PA 15632-8997 | 2012-01-26 |
| 1336303106 | Connie Ruth Clark | Nurse Practitioner | 710 Sw Rock Creek Dr, Stevenson, WA 98648-4418 | 2008-07-10 |
| Street Address |
955 S DURKIN DR STE. B |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161964 | Joyful Living Behavioral Health Inc | Counselor | 107 W Q St, Springfield, OR 97477-2171 | 2020-10-16 |
| 1366055352 | Joshua Dauner | Counselor | 819 N Boonville Ave, Springfield, MO 65802-3831 | 2020-08-28 |
| 1972114411 | Doris Osiimwe Johnson | Counselor | 52 Elaine Cir # 52, Springfield, MA 01109-1205 | 2020-08-10 |
| 1003426610 | Jy Counseling LLC | Counselor | 6054 Forrest Hollow Ln, Springfield, VA 22152-1428 | 2020-08-07 |
| 1912526674 | Amy Christine Russell | Counselor | 317 30th St Apt 304d, Springfield, OR 97478-7619 | 2020-04-13 |
| 1588299184 | Julie Patricia Slover | Counselor | 3331 S Parkview Ave, Springfield, MO 65804-4755 | 2020-03-04 |
| 1356986319 | Three Dirty Birds LLC | Counselor | 805 Lorraine Dr, Springfield, PA 19064-1004 | 2019-11-14 |
| 1992348916 | Tiffany Looney | Counselor | 1705 Centennial Blvd Ste 1, Springfield, OR 97477-3320 | 2019-10-22 |
| 1588206346 | Carrie Stormzand | Counselor | 4546 S Quail Creek Ave, Springfield, MO 65810-1678 | 2019-10-14 |
| 1366084295 | Betty Jean | Counselor | 673 Morris Ave, Springfield, NJ 07081-1512 | 2019-10-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on MS. CONNIE LYNN 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.