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TAKENYA CHIMENE CLARK-JEFFERIES LCSW
NPI 1205087657
Social Worker in Grand Terrace, CA

Active since October 03, 2008PECOS Enrolled
12139 MOUNT VERNON AVE STE 104, GRAND TERRACE, CA 92313(909) 452-5857(909) 527-4811 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 22, 2023, Jan 29, 2021, Sep 11, 2018 (3 updates tracked since 2018).

About Takenya Chimene Clark-jefferies Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAKENYA CHIMENE CLARK-JEFFERIES LCSW (NPI 1205087657) is an individual social worker in Grand Terrace, California, licensed in California (LCS#62241) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205087657
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameTAKENYA CHIMENE CLARK-JEFFERIESCredential: LCSW
Location Address12139 MOUNT VERNON AVE STE 104Grand Terrace, CA 92313-5500
Mailing AddressPo Box 1361Bloomington, CA 92316-0380 · (909) 452-5857 · Fax (909) 527-4813
Phone(909) 452-5857
Fax(909) 527-4811
Sole ProprietorYes
Enumeration DateOctober 3, 2008
Last NPPES UpdateAugust 22, 20233 updates tracked since enumeration
NPPES CertifiedAugust 22, 2023
✔ NPI 1205087657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in CA · LCS#62241
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
12139 MOUNT VERNON AVE STE 104, Grand Terrace, CA 92313
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Other Names 1

Professional Name (2)Takenya Chimene Clark Msw

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Takenya Chimene Clark-jefferies Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERRA VISTA COUNSELING
Community/Behavioral Health
12139 MOUNT VERNON AVE STE 104
GRAND TERRACE, CA 92313
San Bernardino County (909) 452-5857

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 Takenya Clark-jefferies's NPI number?

The NPI number for Takenya Clark-jefferies is 1205087657. It was assigned to this individual provider in the NPPES registry on October 3, 2008. The provider is also known as Takenya Chimene Clark Msw.

Where is Takenya Clark-jefferies located?

Takenya Clark-jefferies practices at 12139 Mount Vernon Ave Ste 104, Grand Terrace, CA 92313. The listed phone number is (909) 452-5857.

What is Takenya Clark-jefferies's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Takenya Clark-jefferies enrolled in Medicare?

Yes. Takenya Clark-jefferies is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Takenya Clark-jefferies was last updated on August 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.