JENNIFER MORGAN CLARK DNP PMHNP NPI 1194933507

NPI Information

NPI: 1194933507
Provider Name: JENNIFER MORGAN CLARK, DNP, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
10 PATEWOOD DR STE 130
GREENVILLE, SC
ZIP 29615
Phone: (864) 455-8988
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Jennifer Morgan Clark, DNP, PMHNP is a psychiatric/mental health nurse practitioner in Greenville, SC with 11 years of experience. Jennifer Morgan Clark, DNP, PMHNP NPI is 1194933507. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10 PATEWOOD DR STE 130
GREENVILLE, SC
ZIP 29615-317
Phone: (864) 455-8988
Fax: (864) 522-5555

The NPI 1194933507 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/18/2007 and was last updated on 5/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	13282	TENNESSEE	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	0024167709	VIRGINIA	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	20752	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP4552	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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