MATTHEW CLARK (NPI# 1417353996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417353996 |
Entity Type | Individual |
Full Name | MATTHEW CLARK |
Practice Address |
360 Bloomfield Ave Ste 301 Windsor CT 06095-2700 |
Practice Telephone | 8606073235 |
Practice Fax Number | 8606073201 |
Mailing Telephone | 8606073235 |
Mailing Fax Number | 8606073201 |
Enumeration Date | 2014-11-12 |
Last Update Date | 2017-01-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
002674 | CT | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033578653 | Matthew Mitchell Clark | Student in an Organized Health Care Education/Training Program | 2644 Crystal Falls Rd, Lexington, KY 40509-4208 | 2016-02-11 |
1154787844 | Matthew Clark | Chiropractor | 5250 S Commerce Dr Ste 155, Murray, UT 84107-5379 | 2016-01-11 |
1811001126 | Matthew David Ayers Clark | Psychologist | 7150 Kalamazoo Ave Se, Ste C, Caledonia, MI 49316-9126 | 2006-08-17 |
1215993308 | Matthew Alexander Clark | Internal Medicine | Ute Mountain Ute Health Center, Complex B Rustling Willow Street, Towaoc, CO 81334-0049 | 2006-04-26 |
1407341134 | Matthew Howard Clark | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905 | 2018-06-25 |
1639674591 | Matthew Anthony Clark | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2018-03-24 |
1588104913 | Matthew Louis Clark | Pharmacist | 4747 Sawmill Rd, Columbus, OH 43220-2490 | 2017-03-04 |
1679949184 | Matthew Clark | Optometrist | 2792 E 146th St, Carmel, IN 46033-7718 | 2015-08-19 |
1902288806 | Matthew Lewis Clark | Dermatology | 8245 Holly Rd Ste 101, Grand Blanc, MI 48439-2443 | 2015-06-26 |
1467872044 | Matthew Thomas Clark | Pediatrics | 2200 Childrens Way, Suite 2404, Nashville, TN 37232-0005 | 2014-04-22 |
Street Address |
360 BLOOMFIELD AVE STE 301 |
City | WINDSOR |
State | CT |
Zip Code | 06095-2700 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255342556 | Sean Timothy Brennan | Physician Assistant | 360 Bloomfield Ave, Suite 209, Windsor, CT 06095-2700 | 2006-08-11 |
1942818968 | Victoria Dionne | Behavior Technician | 360 Bloomfield Ave, Windsor, CT 06095-2700 | 2020-07-15 |
1346875689 | Indigo Counseling Services LLC | Counselor | 360 Bloomfield Ave, Windsor, CT 06095-2700 | 2020-03-06 |
1245896687 | Heather Morgan Haas | Behavioral Analyst | 360 Bloomfield Ave, Windsor, CT 06095-2700 | 2019-05-10 |
1306300397 | Mojdeh Heidari | Family Medicine | 360 Bloomfield Ave, Windsor, CT 06095-2700 | 2019-01-24 |
1235621236 | Trudy Tamara Pearson | Social Worker | 360 Bloomfield Ave, Windsor, CT 06095-2700 | 2018-06-05 |
1801332812 | Clark Counseling Services LLC | Counselor | 360 Bloomfield Ave, Suite 301, Windsor, CT 06095-2700 | 2017-01-13 |
1922470772 | Purple Hearts Home Care LLC | Exclusive Provider Organization | 360 Bloomfield Ave, Suite 301, Windsor, CT 06095-2700 | 2015-10-20 |
1366821886 | Love and Caring Home Care Agency LLC | Home Health | 360 Bloomfield Ave, Windsor, CT 06095-2700 | 2015-05-29 |
1588055818 | Velanda Samuel | Social Worker | 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 | 2015-02-09 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285255992 | Dnd Group of Companies LLC | Psychologist | 204 Old Village Cir, Windsor, CT 06095 | 2020-05-04 |
1811467442 | Joseph C Gaetani Jr. | Specialist | 340 Broad Street Suite 320, Windsor, CT 06095 | 2018-11-27 |
1447629043 | Brittany Higginbotham | Marriage & Family Therapist | 347 Park Avenue, Windsor, CT 06095 | 2015-09-24 |
1457737454 | Eric Han | Dentist | 697 Poquonock Ave, Windsor, CT 06095 | 2015-08-03 |
1265780894 | Annetta Ruth Troche | Nurse Practitioner | 22 Parkwood Drive, Windsor, CT 06095 | 2012-08-29 |
1821234006 | Milna Rosario | Social Worker | 6 Poquonock Avenue, Windsor, CT 06095 | 2008-12-18 |
1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
1972708758 | Price Chopper Inc | Pharmacy | 675 Poquoncock Ave, Windsor, CT 06095 | 2007-06-20 |
1396870358 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 1080 Day Hill Road, Windsor, CT 06095 | 2007-02-22 |
1841342094 | Thomas F. Reif | Psychologist | 32 Maple Avenue, Windsor, CT 06095 | 2007-01-17 |
Find all providers in zip 06095 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518576040 | Carolyn Mae Mader | Counselor | 2025 Bayfront Ct, Windsor, CO 80550-3592 | 2020-07-30 |
1578197349 | Heather M Burkey-skye | Counselor | 1223 Fairfield Ave, Windsor, CO 80550-5822 | 2020-03-02 |
1427680933 | Kelli Price | Counselor | 15 Berrios Hill Rd, Windsor, CT 06095-1000 | 2020-02-12 |
1427694546 | Gerard Fitzgerald | Counselor | 303 Coopers Mills Rd, Windsor, ME 04363-3825 | 2019-11-24 |
1518492297 | Jason Allen | Counselor | 602 Park Edge Cir, Windsor, CO 80550-3255 | 2017-05-01 |
1932553567 | Samantha Sanborn | Counselor | 55 Poquonock Ave, Windsor, CT 06095-2508 | 2016-04-20 |
1114316544 | Rosanna Z Wilson | Counselor | 1 Kellogg St, Windsor, CT 06095-3117 | 2015-01-22 |
1043533557 | Joyce A Erickson | Counselor | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2010-03-11 |
1689792582 | Heather Findlay | Counselor | 841 Us Route 5 N, Windsor, VT 05089-9693 | 2007-03-27 |
1871600619 | Allisyn Hollweg | Counselor | 1170 W Ash St Ste 100, Windsor, CO 80550-4783 | 2006-08-25 |
Find all providers in WINDSOR |
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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.