ANTOINETTE CLARK (NPI# 1629105200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629105200 |
| Entity Type | Individual |
| Full Name | ANTOINETTE CLARK |
| Practice Address |
3809 Rosewood Dr Columbia SC 29205-3533 |
| Mailing Address |
7 Softwood Ln Columbia SC 29229-8019 |
| Practice Telephone | 8037861844 |
| Mailing Telephone | 8037861844 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659836054 | Antoinette Yvette Clark | Behavior Technician | 227 W Ercoupe Dr, Midwest City, OK 73110-5515 | 2019-02-10 |
| 1902089717 | Antoinette Sophia Clark | Licensed Practical Nurse | 106 N Water St, Georgetown, OH 45121-1332 | 2007-12-14 |
| Street Address |
3809 ROSEWOOD DR |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29205-3533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861570293 | Mark Stanley Butkus | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2006-11-02 |
| 1679184154 | Isabella G Gormanson | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2020-08-10 |
| 1598373078 | Julie V. Plane | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2020-07-21 |
| 1235789389 | Brittany Kristina Stembridge | Counselor | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2019-09-19 |
| 1528618675 | Charles Zane Crumpler | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2019-09-19 |
| 1982254033 | Shamekia Shuntell Richardson | Licensed Practical Nurse | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2019-09-19 |
| 1902371198 | Laquita Nesha Harrison | Community/Behavioral Health | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2018-10-04 |
| 1750869749 | Stephanie Alexandra Vanessa Jones | Community/Behavioral Health | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2018-08-01 |
| 1144729153 | Bradley Neal Martin | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2018-02-05 |
| 1659888048 | Taylor Brooke Beckwith | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2018-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462241 | New Life Home Care LLC | In Home Supportive Care | 4423 Ste. D, Devine Street, Columbia, SC 29205 | 2019-11-25 |
| 1689144222 | Jessica M Jarman LLC | Counselor | 610 Holly St., Columbia, SC 29205 | 2018-11-27 |
| 1073083648 | Christopher James Troyer | Psychologist | 2805 Millwood Ave., Columbia, SC 29205 | 2018-11-27 |
| 1891277505 | Daniel Long | Pharmacist | 630 Kilbourne Road, Columbia, SC 29205 | 2018-08-30 |
| 1699126136 | Steven Matthew Ferrufino | Counselor | 417 S Edisto Ave, Columbia, SC 29205 | 2016-06-27 |
| 1619351863 | Deangela Lenore Delaney | Nurse Practitioner | 2739 Laurel Street, Columbia, SC 29205 | 2015-07-17 |
| 1548677131 | Maegan Elizabeth Dean | Pharmacist | 2708 Rosewood Drive, Columbia, SC 29205 | 2014-07-16 |
| 1144561465 | Abby Habicht | Speech-Language Pathologist | 705 Maple St., H 102, Columbia, SC 29205 | 2013-03-12 |
| 1750630562 | Pamela B. Robertson | Pharmacist | 3312 Devine Street, Columbia, SC 29205 | 2012-09-07 |
| 1609124023 | Kristen Anne Tice | Dietitian, Registered | 1029 Deerwood Street, Columbia, SC 29205 | 2012-08-15 |
| Find all providers in zip 29205 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133407 | Julianne Grace Patchan | Counselor | 9518 Sweet Grass Rdg, Columbia, MD 21046-2066 | 2020-10-27 |
| 1386242485 | The Oak Center for Dbt & Counseling Services, LLC | Counselor | 19 E Walnut St Ste D, Columbia, MO 65203-4505 | 2020-10-12 |
| 1477151538 | Gabriela Rios-martinez | Counselor | 10310 Swift Stream Pl Apt 405, Columbia, MD 21044-4899 | 2020-10-12 |
| 1508470840 | Christine Schaub | Counselor | 214 Autumn Run Cir, Columbia, SC 29229-7622 | 2020-09-03 |
| 1639780190 | Courtnay Kopec LLC | Counselor | 6309 Beechwood Dr, Columbia, MD 21046-1008 | 2020-08-10 |
| 1083224828 | Elite Transformant Solutions | Counselor | 6701 Bailey St, Columbia, SC 29203-7454 | 2020-08-06 |
| 1083223671 | Grant B Counseling & Consultation, LLC | Counselor | 702 Wildlife Ln, Columbia, SC 29209-3464 | 2020-07-29 |
| 1992323166 | Deitrich Andera Drayton | Counselor | 517 Howard St, Columbia, SC 29205-3820 | 2020-07-13 |
| 1033736202 | Trinicia Renee Lavon Jackson | Counselor | 6530 Davidson St Apt C1, Columbia, SC 29209-1732 | 2020-07-02 |
| 1497379648 | The Garnet Oak | Counselor | 215 Faircrest Way, Columbia, SC 29229-9244 | 2020-06-03 |
| Find all providers in COLUMBIA | ||||
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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.