Individual provider Active NPI

Jane Elizabeth Clark, RNCS

  • Psychiatric/Mental Health Nurse Practitioner
  • Milford, CT
National Provider Identifier
1639262579
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1952 Issued in CT
Practice address
828 E Broadway
Milford, CT 06460-6215
Phone
(860) 490-0800
Fax
(888) 222-1049
NPI assigned
Oct 2, 2006
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1952 CT Primary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 001952 CT

Addresses

Primary practice location

828 E Broadway
Milford, CT 06460-6215

Mailing address

675 Tower Ave
Suite 301
Hartford, CT 06112-1273
Phone (860) 714-2750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070212000381 CT Practitioner - Certified Clinical Nurse Specialist (CNS) 7214969302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Keystone Cir
Avon, CT 06001-3312

45 Wadsworth St
Hartford, CT 06106-5052

896 Asylum Ave
Hartford, CT 06105-1901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1952CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Inc - Archdiocese of Hartford CurrentSince Aug 7, 2014 Accepting new patients
Catholic Charities, Inc. - Archdiocese of Hartford CurrentSince Aug 1, 2017 Accepting new patients
Bhcare, Inc. Past Accepting new patients
Medoptions Behavioral Health Assoc, LLC Past Accepting new patients
Behavioral Health Network, Inc Past Accepting new patients

Locations

45 Wadsworth St
Hartford, CT 06106
Phone 8605271124283

90 Franklin Sq
New Britain, CT 06051
Phone (860) 225-3561

132 Grove St
Torrington, CT 06790
Phone (860) 482-5558

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/BHcare/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1639262579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-2750",
            "fax_number": "860-714-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 E BROADWAY",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064606215",
            "telephone_number": "860-490-0800",
            "fax_number": "888-222-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "credential": "RNCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "1952",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CT",
            "license": "001952",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.