JEANETTA CLARK
NPI 1003298639
Counselor - School in Tullahoma, TN
About Jeanetta Clark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEANETTA CLARK (NPI 1003298639) is an individual school provider in Tullahoma, Tennessee and active in the NPI registry since June 2015.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jeanetta Clark's NPI number?
The NPI number for Jeanetta Clark is 1003298639. It was assigned to this individual provider in the NPPES registry on June 19, 2015.
Where is Jeanetta Clark located?
Jeanetta Clark practices at 1803 N. Jackson St Centerstone Of Tennessee, Tullahoma, TN 37388. The listed phone number is (615) 463-6643.
What is Jeanetta Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in School, with taxonomy code 101YS0200X.
When was this NPI record last updated?
The NPPES record for Jeanetta Clark was last updated on June 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jeanetta Clark · NPI 1003298639
School provider in Tullahoma, Tennessee. Individual provider, active in the CMS NPPES registry since June 19, 2015.
## Identity
- **NPI:** 1003298639 (Entity type: Individual)
- **Enumerated:** June 19, 2015
- **Primary specialty:** Counselor - School · taxonomy 101YS0200X
- **Sole proprietor:** No
## Practice location
- **Address:** 1803 N. JACKSON ST, CENTERSTONE OF TENNESSEE, Tullahoma, TN 37388
- **Phone:** (615) 463-6643
## Record status
- **NPPES last updated:** June 19, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1003298639) · Data from the CMS NPPES public registry.