Janelle Clark, M.S.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133000648 Issued in VA

Practice address

4000 Genesee PL
Suite 205
Woodbridge, VA 22192-8302

Phone

(571) 402-7499

Fax

(571) 402-7237

NPI assigned

Jul 22, 2016

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

Other names 1

• Janelle Lusk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• Paragon Autism Services, LLC

  • Behavior Analyst
  • Fredericksburg, VA
  • NPI 1720427875
  NPD (past)

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1821441072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 PRINCESS ANNE ST",
            "address_2": "SUITE 407",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224015801",
            "telephone_number": "540-479-3889",
            "fax_number": "540-479-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 GENESEE PL",
            "address_2": "SUITE 205",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928302",
            "telephone_number": "571-402-7499",
            "fax_number": "571-402-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANELLE",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANELLE",
            "last_name": "LUSK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sierra Clair
• Susan Carol Clance
• Anthony Clark, LCSW
• Benjamin Ryan Clark, LPC
• Hershelle Andera Clark
• Kristin Marie Jerome Clark, PA-C
• Taiia Clarke
• Clary Healthcare Services LLC
• C. Angela Clary-Duckworth, COTA
• Kaitlyn Nichole Clary

• Behavior Analyst in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.