Tawanda Clarke, M.A., LPC, CAADC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

609 Southland Ave
Portage, MI 49024-2753

Phone

(269) 808-6556

NPI assigned

Oct 29, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Diane M Kanous

  • Counseling Psychologist
  • Kalamazoo, MI
  • NPI 1588837736
  Medicare reassignment NPD
• Dorman and Associates PLC

  • Psychologist
  • Kalamazoo, MI
  • NPI 1275737413
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1033398987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SOUTHLAND AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242753",
            "telephone_number": "269-808-6556",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SOUTHLAND AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490242753",
            "telephone_number": "269-808-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "TAWANDA",
        "credential": "M.A., LPC, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kalamazoo",
            "affiliation": "N",
            "endpointDescription": "therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Kalamazoo",
            "address_1": "609 Southland Ave",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490242753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Clarey
• Cheyann Clark
• Kimberly Carol Clark, B.S. CMT
• Krystle Clark, RD
• Nautica Clark
• Michael Maurice Claussen, PA-C
• Kimberly Clawson
• Krista Anne Climer
• Rebecca Clore, LMSW
• Andrea D Coats, RN

• Counselor in Portage, MI
• Providers in Portage, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.