Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jettanna Burruss- Clark

Individual provider Counselor · NPI 1902590227

Jettanna Burruss- Clark is a Counselor in Waldorf, Maryland. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
3
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Practice location Address checks out

22 Meadow Pl
Waldorf, MD 20601-2924
Phone: (240) 810-3952
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Counselor Taxonomy 101Y00000X
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1902590227
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 8, 2023
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026

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