TERESA OCTAVIA CLARK (NPI# 1962931733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962931733 |
| Entity Type | Individual |
| Full Name | TERESA OCTAVIA CLARK |
| Credential | QP |
| Practice Address |
9403 Mansfield Rd Shreveport LA 71118-3815 |
| Practice Telephone | 3188618938 |
| Practice Fax Number | 3188623554 |
| Mailing Telephone | 3188618938 |
| Mailing Fax Number | 3188623554 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2019-08-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144779778 | Teresa Clark | Contractor | 2304 W Gordon Ave Apt 218, Albany, GA 31707-4607 | 2016-09-23 |
| 1750624904 | Teresa Louise Clark | Licensed Vocational Nurse | 2121 E 1st St, 306, Long Beach, CA 90803-2418 | 2013-04-05 |
| 1538373337 | Teresa Clark | Counselor | 721 Bath Rd, Wiscasset, ME 04578-4830 | 2007-05-10 |
| 1689759516 | Teresa Marie Clark | Dental Assistant | 7218 Birch Bark Drive, Fairview, TN 37062 | 2006-10-26 |
| 1538194261 | Teresa Elaine Clark | Internal Medicine | 2920 S Pharr Ct Nw, Atlanta, GA 30305-2104 | 2006-07-11 |
| 1407827561 | Teresa Jean Clark | Physical Therapist | 40900 Merchants Lane, Suite 202, Leonardtown, MD 20650 | 2006-01-27 |
| 1235585563 | Teresa A Clark | Nurse Practitioner | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2016-05-05 |
| 1912307109 | Teresa M Clark | Occupational Therapist | 301 Highway 65 S, Mora, MN 55051-1899 | 2014-08-26 |
| 1871853622 | Teresa Sha Clark | Social Worker | 700 Childrens Dr, Clinical Services and Care Coordination, Columbus, OH 43205-2664 | 2012-05-25 |
| 1962701482 | Teresa May Clark | Occupational Therapist | 815 Triplett St, Owensboro, KY 42303-3564 | 2011-03-23 |
| Street Address |
9403 MANSFIELD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245570092 | Kellie Lynn Speed | Counselor | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2013-02-14 |
| 1437750700 | Hearise Hawkins | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-11-03 |
| 1396343646 | Gabrielle Cecile Kirchem | Counselor | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-10-09 |
| 1063022770 | Lakenya Louis | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-08-06 |
| 1528676251 | Demario Demond Dinkins | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-07-20 |
| 1790393759 | Jeremiah M Pounds | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-07-16 |
| 1396363123 | Grafton Latron Tucker Jr. | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-07-08 |
| 1528682705 | Marcus Dione Hooper | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-06-03 |
| 1811510837 | Tiffany Washington | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-05-26 |
| 1912529173 | Jala Rollins | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2020-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360887 | Halena Jones | Case Manager/Care Coordinator | 9409 Chaparral Ln, Shreveport, LA 71118-4337 | 2020-09-11 |
| 1598376196 | Michaela Nicole Bradley | Case Manager/Care Coordinator | 10021 Stratmore Cir, Shreveport, LA 71115-3416 | 2020-08-17 |
| 1619585791 | Kimberly Bissell | Case Manager/Care Coordinator | 7505 Pines Rd Ste 1115, Shreveport, LA 71129-3900 | 2020-07-15 |
| 1902414170 | Unique Lashae Lister | Case Manager/Care Coordinator | 2611 Corbitt St, Shreveport, LA 71108-2805 | 2020-07-14 |
| 1407474828 | Angela Harris | Case Manager/Care Coordinator | 1111 W 70th St Apt 93, Shreveport, LA 71106-3558 | 2020-07-13 |
| 1669096921 | Ryan Barham | Case Manager/Care Coordinator | 824 Oneonta St, Shreveport, LA 71106-1130 | 2020-06-02 |
| 1922621085 | Julian White | Case Manager/Care Coordinator | 8529 Grover Pl, Shreveport, LA 71115-2707 | 2020-05-24 |
| 1396368817 | Shannon Marie Cannon | Case Manager/Care Coordinator | 1543 Summers St, Shreveport, LA 71108-3131 | 2020-05-19 |
| 1730701954 | Brianna Mason | Case Manager/Care Coordinator | 1533 Marshall St, Shreveport, LA 71101-3941 | 2020-05-11 |
| 1295355238 | Angela Rice | Case Manager/Care Coordinator | 2704 Frostwood Dr, Shreveport, LA 71108-5524 | 2020-04-20 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
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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.