Provider Demographics
NPI:1104122480
Name:JP CLARKE AND ASSOCIATES,LLC
Entity type:Organization
Organization Name:JP CLARKE AND ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:PASSLEY-CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:443-869-5791
Mailing Address - Street 1:1011 HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-2429
Mailing Address - Country:US
Mailing Address - Phone:443-869-5791
Mailing Address - Fax:443-646-0628
Practice Address - Street 1:8828 TELEGRAPH ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1130
Practice Address - Country:US
Practice Address - Phone:443-869-5791
Practice Address - Fax:443-646-0268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty