Clarissa Jo Middleton, P.H.D., M.ED.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

4040 Pinnacle Way
Hephzibah, GA 30815-6135

Phone

(863) 329-2510

NPI assigned

Apr 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 14

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education, Doctor of Philosophy

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

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            "telephone_number": "863-329-2510"
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    "practiceLocations": [],
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        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "P.H.D., M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-21",
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        "certification_date": "2022-04-21",
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• Early Intervention Provider Agency in Hephzibah, GA
• Providers in Hephzibah, GA by specialty
• Early Intervention Provider Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.