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JETTANNA BURRUSS- CLARK
NPI 1902590227
Case Manager/Care Coordinator in Waldorf, MD

Active since June 08, 2023
22 MEADOW PL, WALDORF, MD 20601(240) 810-3952 Get Directions Write a Review

NPPES record last updated: February 11, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 14, 2023, Jun 8, 2023 (2 updates tracked since 2023).

About Jettanna Burruss- Clark NPPES

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

JETTANNA BURRUSS- CLARK (NPI 1902590227) is an individual case manager/care coordinator provider in Waldorf, Maryland and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1902590227
Entity TypeIndividualFemale
Primary Taxonomy171M00000X
Provider Legal NameJETTANNA BURRUSS- CLARK
Location Address22 MEADOW PLWaldorf, MD 20601-2924
Mailing Address22 Meadow PlWaldorf, MD 20601-2924 · (240) 810-3929
Phone(240) 810-3952
Sole ProprietorYes
Enumeration DateJune 8, 2023
Last NPPES UpdateFebruary 11, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2026
✔ NPI 1902590227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCommunity Health WorkerTaxonomy 172V00000X
22 MEADOW PL, Waldorf, MD 20601
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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 Jettanna Burruss- Clark's NPI number?

The NPI number for Jettanna Burruss- Clark is 1902590227. It was assigned to this individual provider in the NPPES registry on June 8, 2023.

Where is Jettanna Burruss- Clark located?

Jettanna Burruss- Clark practices at 22 Meadow Pl, Waldorf, MD 20601. The listed phone number is (240) 810-3952.

What is Jettanna Burruss- Clark's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Jettanna Burruss- Clark was last updated on February 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.