Active NPI
Jasmine Makayla Clark, WRAPAROUND
- Mental Health Counselor
- Carmel, IN
National Provider Identifier
1134846330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 100073590A
- Practice address
- 697 Pro Med LN
Carmel, IN 46032-5323 - Phone
- (317) 587-0517
- NPI assigned
- Oct 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 100073590A | IN | Primary |
Addresses
Primary practice location
697 Pro Med LN
Carmel, IN 46032-5323
Mailing address
9615 E 148TH St Ste 1
Noblesville, IN 46060-4371
Phone (317) 587-0517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100073590A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666828800000",
"number": "1134846330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9615 E 148TH ST STE 1",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460604371",
"telephone_number": "317-587-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "697 PRO MED LN",
"city": "CARMEL",
"state": "IN",
"postal_code": "460325323",
"telephone_number": "317-587-0517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JASMINE",
"middle_name": "MAKAYLA",
"credential": "WRAPAROUND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-27",
"last_updated": "2022-10-27",
"certification_date": "2022-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "100073590A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.