Justina Clark, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP3388 Issued in NV

Practice address

301 N Pecos Rd Ste a
Henderson, NV 89074-1350

Phone

(702) 566-8255

NPI assigned

Apr 25, 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

Other names 1

• Justina Mayer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1922796325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 COLORADO ST",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PECOS RD STE A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890741350",
            "telephone_number": "702-566-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JUSTINA",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP3388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINA",
            "last_name": "MAYER",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dennis Howard Clark, D.D.S.
• Edward Clark, MD
• Jathiyah Clark
• Jesse Clark
• Julia Clark I
• Kathy Clark
• Nyana Clark
• Raynelle D Clark
• Sherry Clark
• Vanessa Clark

• Speech-Language Pathologist in Henderson, NV
• Providers in Henderson, NV by specialty
• Speech-Language Pathologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.