Active NPI
Cammie J Clark, ED. SPECIALIST
- School Psychologist
- Thornton, CO
National Provider Identifier
1457074247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 12911 Rosemary St
Thornton, CO 80602-8408 - Phone
- (850) 630-8887
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | WA | Primary |
Addresses
Primary practice location
12911 Rosemary St
Thornton, CO 80602-8408
Mailing address
12911 Rosemary St
Thornton, CO 80602-8408
Phone (850) 630-8887
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1457074247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12911 ROSEMARY ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "806028408",
"telephone_number": "850-630-8887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12911 ROSEMARY ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "806028408",
"telephone_number": "850-630-8887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CAMMIE",
"middle_name": "J",
"credential": "ED. SPECIALIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-26",
"last_updated": "2022-09-26",
"certification_date": "2022-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.