Mary Theresa Clark, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2264 Baltimore Pike
Oxford, PA 19363-4007

Phone

(610) 932-0758

Fax

(610) 932-7744

NPI assigned

Apr 4, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Agape Wellness Group

  • Mental Health Counselor
  • Oxford, PA
  • NPI 1356951586
  NPD
• Empowerment Resource Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
  • NPI 1992889562
  NPD

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1821793258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E LOCUST ST APT 2",
            "city": "OXFORD",
            "state": "PA",
            "postal_code": "193631305",
            "telephone_number": "610-357-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 BALTIMORE PIKE",
            "city": "OXFORD",
            "state": "PA",
            "postal_code": "193634007",
            "telephone_number": "610-932-0758",
            "fax_number": "610-932-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Brown, RN 534133
• Enzo Bucci, RPH
• Meredith Pool Burnett, LCSW MA ED
• Jonathan Eric Campbell, MSPT
• Chiropractic Services, P.a.
• Tara Cloud
• Boris Emilio Cordova-Canas, MSN, APRN, FNP-C
• Virginia Cristofoletti
• Kimberly Marie Cruser, BSN, IBCLC
• Darlene Damore

• Mental Health Counselor in Oxford, PA
• Providers in Oxford, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.