Prevail Psychiatric Services

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PREVAIL PSYCHIATRIC SERVICES

Practice address

1978 Adolphus St
Maplewood, MN 55117-1904

Phone

(651) 724-2905

NPI assigned

Nov 28, 2022

Organization subpart

No

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

Authorized official

Name

Jessica Clark, DNPNPI 1457914160

Title

Psychiatric Nurse Practitioner

Phone

(651) 724-2905

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Marion Clark, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
  • NPI 1457914160
  NPD Authorized official

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1780394171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1978 ADOLPHUS ST",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551171904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 ADOLPHUS ST",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551171904",
            "telephone_number": "651-724-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVAIL PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "651-724-2905",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jclark@prevailpsychiatricservices.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1978 Adolphus St",
            "city": "Maplewood",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551171904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gayla Marie Pleggenkuhle, PT
• Danny Paul Porter, LICSW
• Johnathan Scott Powell
• Laura Ann Powers, PA-C
• James L Prall, MD
• Professional Service Group
• Richard Joseph Prokosch
• Totianna Renee Prudhomme, NP
• Nyan Pyae, M.D.
• Arsam Qazi, PA

• Psychiatry Physician in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.

Verify at the official NPI Registry.