Mattea Nicole Clarke, MPH, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-312861 Issued in GA

Practice address

213 E Whatley St
Pooler, GA 31322-3131

Phone

(209) 675-5661

NPI assigned

Apr 24, 2024

Last updated

Apr 24, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1609622414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 E WHATLEY ST",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313223131",
            "telephone_number": "209-675-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 E WHATLEY ST",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313223131",
            "telephone_number": "209-675-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MATTEA",
        "middle_name": "NICOLE",
        "credential": "MPH, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "GA",
            "license": "L-312861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Coastal Community Health Services, Inc. (Coastal Community Health - Pooler)

• Lactation Consultant (Non-RN) in Pooler, GA
• Providers in Pooler, GA by specialty
• Lactation Consultant (Non-RN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.