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

Terri Marie Clack, PMHNP-BC

Individual provider Primary Care Nurse Practitioner · NPI 1487169173

Terri Marie Clack, PMHNP-BC is a Nurse Practitioner in Boston, Massachusetts. Qualified in 2017, 9 years ago. Practices as a sole proprietor, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Georgia and Massachusetts.

Years since qualifying
9
Licensed in
GA, MA
In the registry since
2017
Specialties on file
3
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

1 Washington Mall Ste 1045
Boston, MA 02108-2603
Phone: (617) 249-4036
Fax: (617) 843-9320
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 169 Libbey Industrial Pkwy, Weymouth, MA 02189-3189 — (781) 551-0999

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence RN2362195 (MA)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence RN214255 (GA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence RN214255 (GA)

Record details

NPI number1487169173
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedDecember 5, 2017
Last updated in NPPESApril 29, 2025
Certification dateApril 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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