| Dr Jane Clark Llc | |
|
15 Meadow St Litchfield CT 06759-3504 | |
| (860) 490-0800 | |
| (888) 859-4374 |
| Full Name | Dr Jane Clark Llc |
|---|---|
| Speciality | Counselor |
| Location | 15 Meadow St, Litchfield, Connecticut |
| Authorized Official Name and Position | Jane Elizabeth Clark (APRN) |
| Authorized Official Contact | 8604900800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jane Clark Llc 2 Keystone Cir Avon CT 06001-3312 Ph: (860) 490-0800 | Dr Jane Clark Llc 15 Meadow St Litchfield CT 06759-3504 Ph: (860) 490-0800 |
| NPI Number | 1528426343 |
|---|---|
| Provider Enumeration Date | 02/08/2016 |
| Last Update Date | 02/08/2016 |
| Medicare PECOS PAC ID | 4284930140 |
|---|---|
| Medicare Enrollment ID | O20160303000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528426343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 001952 (Connecticut) | Primary |
| Provider Name | Jane E Clark |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1639262579 PECOS PAC ID: 7214969302 Enrollment ID: I20070212000381 |
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