Jacqueline Kathleen Clarke Jemmott, PHD

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT2821 Issued in FL

Practice address

7203 Pine Forest Rd
Pensacola, FL 32526

Phone

(954) 274-0507

NPI assigned

Sep 22, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, TX, GA, DC4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, GA, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1348272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1760733398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325330835",
            "telephone_number": "954-274-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7203 PINE FOREST RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32526",
            "telephone_number": "954-274-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE JEMMOTT",
        "first_name": "JACQUELINE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-22",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MCAP010627",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MT2821",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760733398",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Stacie Clark, COTA
• Richard O Clark, PAC
• Sarah Shivers Clark, NP-C
• William Buren Clark, MD
• Zelnnetta Clark
• Adam Clarke, R.PH.
• Bryan Michael Clarke, IDC
• Maria Brianna Clarke
• Victoria Clarke, APRN
• Colleen Michelle Class, PA

• Marriage & Family Therapist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.