Valarie Golden Clark, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Lake Charles, LA
NPI 1285288951 · NPPES record last updated Sep 26, 2022
Key facts
- NPI
- 1285288951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 207541 (LA)
- Practice address
- 2829 4TH Ave Ste 150
Lake Charles, LA 70601-7897 - Phone
- (337) 480-7800
- Fax
- (337) 474-4552
- NPI assigned
- Jul 30, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- MMG Archer Institute, LLC
Practice addresses (Care Compare)
2615 Enterprise Blvd
Suite a
Lake Charles, LA 70601-7686
Phone (337) 480-7800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200529002412 | LA | Practitioner - Nurse Practitioner | 1355762378 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorixhealth at-Home, LLC | Nurse Practitioner | Current |
Accepting new patients |
| MMG Archer Institute, LLC | Current |
Accepting new patients | |
| Southwest Louisiana Hospital Association Inc | Past |
Accepting new patients |
Locations
2615 Enterprise Blvd
Ste A
Lake Charles, LA 70601
Phone (337) 480-7800
2829 4th Ave
Ste 150
Lake Charles, LA 70601
Phone (337) 477-7091
3445 N Causeway Blvd
Ste 600
Metairie, LA 70002
Phone (504) 835-4919
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 207541 | LA | Yes |
Addresses
Primary practice location
2829 4TH Ave Ste 150
Lake Charles, LA 70601-7897
Mailing address
2829 4TH Ave Ste 150
Lake Charles, LA 70601-7897
Phone (337) 480-7805
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2535307 | Medicaid | LA |
Other providers in Lake Charles, LA
- Lakeisha Clark
- Michael Dwayne Clark
- Rebecca Theresa Clark
- Sabrina Clark
- Tersia Clark
- Classic Chiropractic Care Clinic, LLC
- Madison Claudel
- Roger Clausen
- Joy Charmaine Clement Derise
- Bilitsia Trinette Clement
All providers in Lake Charles, LA · Psychiatric/Mental Health Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.