Brandi L. Clark

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

2205 Spanish Town Ave
North Las Vegas, NV 89031-0903

Phone

(702) 658-9563

NPI assigned

Apr 23, 2013

Sex

Female

Sole proprietor

Yes

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

Practice roles

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

• Children and Adolescents Mentoring Services,LLC

  • Community/Behavioral Health Agency
  • North Las Vegas, NV
  • NPI 1649518853
  NPD (past)

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1649614488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MAPLE PINES AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890816802",
            "telephone_number": "734-890-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 SPANISH TOWN AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310903",
            "telephone_number": "702-658-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRANDI",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nereida Clark Jacinto
• Clark Schillinger Emergency Group, PC
• Wanda Leigh Clark- Gantt
• Waiella L Clark-Stephens, MBA
• Allison Janette Clark
• Calvin J Clark
• Chad Curtis Clark
• Cherelle Clark
• Christopher Clark
• Izabella Andrea Clark

• Community/Behavioral Health Agency in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.