Healthcare Provider Details

I. General information

NPI: 1184469934
Provider Name (Legal Business Name): CLARKE PSYCH AND WELLNESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3361 COMMODORE CT
WEST PALM BEACH FL
33411-6481
US

IV. Provider business mailing address

7754 OKEECHOBEE BOULEVARD 445
WEST PALM BEACH FL
33411-6481
US

V. Phone/Fax

Practice location:
  • Phone: 561-331-3577
  • Fax:
Mailing address:
  • Phone: 561-331-3577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NADINE CLARKE
Title or Position: REGISTERED AGENT
Credential: APRN, PMHNP-BC
Phone: 561-331-3577