Tersia Clark

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2110 Oak Park Blvd
Lake Charles, LA 70601

Phone

(337) 475-0324

NPI assigned

Sep 8, 2016

Last updated

Jun 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1336696228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-475-0324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 Kirkman St Ste C",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706015391",
            "country_code": "US",
            "telephone_number": "337-990-5306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERSIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keidra Clark, MSN, RN
• Lakeisha Clark
• Michael Dwayne Clark
• Rebecca Theresa Clark, RN
• Sabrina Clark, PSS
• Valarie Golden Clark, NP
• Classic Chiropractic Care Clinic, LLC
• Madison Claudel, DDS
• Roger Clausen
• Joy Charmaine Clement Derise, MASSAGE THERAPIST

• Case Manager/Care Coordinator in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.