Provider Demographics
NPI:1053928572
Name:CLARK, BRITTNEY MICHELLE (PMHNP)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:MICHELLE
Last Name:CLARK
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 S INDEPENDENCE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1178
Mailing Address - Country:US
Mailing Address - Phone:757-490-6463
Mailing Address - Fax:
Practice Address - Street 1:2101 E PARHAM RD STE 102
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2234
Practice Address - Country:US
Practice Address - Phone:804-799-9292
Practice Address - Fax:757-930-6464
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180172363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health