Clarke Counseling and Psychological Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CLARKE COUNSELING AND PSYCHOLOGICAL SERVICES

Practice address

710 Oakfield Dr
Brandon, FL 33511-4938

Phone

(813) 445-8575

Fax

(813) 649-8085

NPI assigned

Oct 8, 2019

Last updated

Nov 8, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nickeisha K Clarke, PSYDNPI 1245710904

Title

Provider

Phone

(813) 445-8575

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Psychologist office Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nickeisha Clarke, PSYD

  • Clinical Psychologist
  • Lakeland, FL
  • NPI 1245710904
  NPD Authorized official

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1063054310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 OAKFIELD DR STE 153",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114954",
            "telephone_number": "813-445-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114938",
            "telephone_number": "813-445-8575",
            "fax_number": "813-649-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKE COUNSELING AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "NICKEISHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "813-445-8575",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245710904",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychologist office",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Psychologist office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina L Clark, PA-C
• Deniesha Clark
• Jennifer Christine Clark
• Ronald Joseph Clark, M.S., BCBA
• Shelly A Clark
• Claire Clausen, OTR/L
• Jenniffer Carola Clayton, PSW
• Samantha Clayton
• Clearmedica Medical Centers, LLC
• Aaron Clemons

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brandon, FL
• Providers in Brandon, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.