CAROLINE LEE CLARK (NPI# 1962771568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962771568 |
| Entity Type | Individual |
| Full Name | CAROLINE LEE CLARK |
| Credential | ANP |
| Practice Address |
31 Heath St Jamaica Plain MA 02130-1650 |
| Mailing Address |
4 Rindge Ter Cambridge MA 02140-1826 |
| Practice Telephone | 6175236400 |
| Mailing Telephone | 6174605394 |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2017-01-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN2273680 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992205975 | Caroline Clark | Counselor | 1878 S Genoa St, Aurora, CO 80017-4620 | 2018-02-16 |
| 1356956452 | Caroline Clark | Clinical Nurse Specialist | 136 Mountainview Blvd, Basking Ridge, NJ 07920-3444 | 2020-09-15 |
| 1619488350 | Caroline June Clark | Marriage & Family Therapist | 1489 W Warm Springs Rd, Henderson, NV 89014-7635 | 2017-10-20 |
| 1366979825 | Caroline Gray Clark | Social Worker | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2017-05-16 |
| 1083151047 | Caroline Clark | Physical Therapist | 80 Seven Hills Blvd, Suite 105, Dallas, GA 30132-0574 | 2017-01-27 |
| 1992189237 | Caroline Shaffner Clark | Physician Assistant | 2001 Randolph Rd, Charlotte, NC 28207-1215 | 2015-07-16 |
| 1336536317 | Caroline Clark | Social Worker | 790 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2015-04-17 |
| 1972933810 | Caroline Carmela Clark | Psychiatry & Neurology | 4301 Wilson St, Fort Sill, OK 73503-4472 | 2013-11-13 |
| 1033487376 | Caroline Kelly Clark | Social Worker | 121 London Rd, Asheville, NC 28803-2707 | 2011-12-01 |
| 1861586182 | Caroline Clark | Nurse Practitioner | 602 E Nob Hill Blvd, Yakima, WA 98901-3534 | 2006-10-03 |
| Street Address |
31 HEATH ST |
| City | JAMAICA PLAIN |
| State | MA |
| Zip Code | 02130-1650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801916176 | Family Service Association of Greater Boston | Community/Behavioral Health | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2007-03-30 |
| 1841728300 | Carmel Trinity Drewes | Social Worker | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2017-05-30 |
| 1407304645 | Jasmine Altagracia Cespedes Mejia | Behavioral Analyst | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2016-09-16 |
| 1356899512 | Lisa Bailey-laguerre | Counselor | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2016-09-16 |
| 1831646090 | Susana Vanessa Diaz | Social Worker | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2016-09-06 |
| 1245787670 | Guled Adan | Counselor | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2016-09-01 |
| 1295194892 | Yasira Santos Medina | Counselor | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2016-02-11 |
| 1790142537 | Jessica Souris | Social Worker | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2016-01-25 |
| 1417327859 | Claudia Briceno De Ratmiroff | Counselor | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2015-09-28 |
| 1891165361 | Campbell Swift | Social Worker | 31 Heath St, Jamaica Plain, MA 02130-1650 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913121 | Virginia Dawn Pratt | Social Worker | Ethos, 555 Amory Street, Jamaica Plain, MA 02130 | 2020-08-19 |
| 1689139917 | Lina Skiba | Speech-Language Pathologist | Thom Child & Family Services, 555 Armory St, Jamaica Plain, MA 02130 | 2019-01-31 |
| 1841775442 | Melissa Rocklen | Social Worker | 30 Germania St Bldg C, Jamaica Plain, MA 02130 | 2018-09-28 |
| 1902389281 | Susan N. Berkman | Social Worker | 111 Perkins St., Apt.120, Jamaica Plain, MA 02130 | 2018-09-12 |
| 1326551912 | Cindy Tromp | Counselor | Arbour Hospital, 49 Robinwood Ave, Jamaica Plain, MA 02130 | 2017-11-06 |
| 1811415128 | Jesse Myles Carmen | Social Worker | 555 Armory Street, Jamaica Plain, MA 02130 | 2017-09-07 |
| 1881119410 | Melanie Suzanne Witman | Counselor | 1125 Centre Street, Boston, MA 02130 | 2017-08-04 |
| 1740702125 | Farah Clermont | Counselor | 3815 Washington St., Jamaica Plain, MA 02130 | 2017-07-07 |
| 1346777554 | Anjalie L Pieres | Counselor | 157 Green Streey, Jamaica Plain, MA 02130 | 2017-05-18 |
| 1316480098 | Caroline Amina Shaw-moss | Counselor | 7 Burr St., Boston, MA 02130 | 2016-11-29 |
| Find all providers in zip 02130 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639552 | Kelly Ann Hancock | Nurse Practitioner | 6 Margot Ln, East Bridgewater, MA 02333-1689 | 2020-11-03 |
| 1366042715 | Jacqueline Ann Owens | Nurse Practitioner | 32 Hammond Ave, Cohasset, MA 02025-1928 | 2020-10-27 |
| 1144829177 | Amiee N Caruso | Nurse Practitioner | 26 Queen St Ste 4, Worcester, MA 01610-2473 | 2020-10-21 |
| 1629676234 | Sandpiper Wellness, LLC | Nurse Practitioner | 345 Union St Unit 5, New Bedford, MA 02740-3679 | 2020-10-15 |
| 1912505777 | Samantha Deglaoui | Nurse Practitioner | 1 Clarks Hl Ste 302, Framingham, MA 01702-8172 | 2020-10-14 |
| 1699372235 | Square Behavioral Health, LLC | Nurse Practitioner | 733 Turnpike St # 162, North Andover, MA 01845-6137 | 2020-10-06 |
| 1184221046 | Abdonne Ngo Nyele Mbouadeu | Nurse Practitioner | 34 Tannery Rd, Sturbridge, MA 01518-1171 | 2020-10-05 |
| 1013524164 | Atlee Quarrier | Nurse Practitioner | 29 Birch Meadow Rd, Merrimac, MA 01860-1826 | 2020-09-23 |
| 1669086997 | Unique Psych Services LLC | Nurse Practitioner | 10 Mazzeo Dr Ste 201f, Randolph, MA 02368-3433 | 2020-09-03 |
| 1457961138 | Savina Nicole Setze | Nurse Practitioner | 15 N Beacon St Apt 914, Allston, MA 02134-1941 | 2020-08-06 |
| Find all providers with the same taxonomy | ||||
| City | JAMAICA PLAIN |
| Zip Code | 02130 |
Please comment or provide details below to improve the information on CAROLINE LEE 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.