PAUL EDWARD CLARK (NPI# 1124594742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124594742 |
| Entity Type | Individual |
| Full Name | PAUL EDWARD CLARK |
| Credential | LCSW |
| Practice Address |
100 Emancipation Dr Hampton VA 23667-0001 |
| Mailing Address |
132 Lighthouse Dr Portsmouth VA 23703-5473 |
| Practice Telephone | 7577229961 |
| Mailing Telephone | 7574345211 |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
0904010740 | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235540931 | Paul A Clark | Physical Therapist | 410 Avenue G, Levelland, TX 79336-3719 | 2014-05-15 |
| 1154338945 | Paul K Clark | Chiropractor | 725 E Commercial Ave, Lowell, IN 46356-2303 | 2006-08-02 |
| 1396769154 | Paul Anthony Clark | Dentist | 759 E 200th St, Euclid, OH 44119-2504 | 2006-07-26 |
| 1619362597 | Paul Ray Clark | Student in an Organized Health Care Education/Training Program | 6431 Fannin St, Msb 4.331, Houston, TX 77030-1501 | 2015-03-30 |
| 1174939102 | Paul Clark | Physical Therapist | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2014-07-10 |
| 1619388659 | Paul Richard Clark | Student in an Organized Health Care Education/Training Program | 2500 N State St, Department of Neurosurgery, Jackson, MS 39216-4500 | 2014-05-13 |
| 1083051684 | Paul E Clark | Social Worker | 47 Town St, Norwich, CT 06360-2315 | 2013-05-23 |
| 1306289699 | Paul Allen Clark | Occupational Therapist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2013-04-17 |
| 1174893945 | Paul G Clark | Social Worker | 4400 University Dr, Fairfax, VA 22030-4422 | 2012-01-10 |
| 1841569878 | Paul Thomas Clark | Counselor | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2011-12-20 |
| Street Address |
100 EMANCIPATION DR |
| City | HAMPTON |
| State | VA |
| Zip Code | 23667-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073518916 | Therese P Montoya | Physical Medicine & Rehabilitation | 100 Emancipation Dr, Hampton, VA 23667 | 2005-06-16 |
| 1285241570 | Larry N. Wootten | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-09-30 |
| 1487266631 | Jason Jemale Hall | Counselor | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-08-19 |
| 1790395085 | Caitlyn Moody | Pharmacist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-08-03 |
| 1639788268 | Shan S. Wong | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-07-29 |
| 1205454352 | Charity Seitz | Psychologist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-07-06 |
| 1629694617 | Michael William Olsavicky | Pharmacist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-06-25 |
| 1659997914 | John David Kauffman | Pharmacist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-06-23 |
| 1790301406 | Lineisha Williams | Social Worker | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2020-06-18 |
| 1215557335 | Katy Hughes Fedorko | Physician Assistant | 100 Emancipation Dr, Hampton, VA 23667-2906 | 2020-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124447388 | Brian Pho Bui | Psychiatry & Neurology | Hampton Veterans Affairs 100 Emancipation Dr, Hampton, VA 23667 | 2014-04-15 |
| 1275786741 | Melissa Ann Palka | Nurse Practitioner | Hampton Va Medical Center, 100 Emancipation Dr., Hampton, VA 23667 | 2008-10-28 |
| 1639107741 | Lawrence Monroe Brown Jr. | Social Worker | Hampton Vamc, 100 Emancipation Dr, Hampton, VA 23667 | 2006-06-29 |
| 1578528030 | Harold Steven Smuckler | Family Medicine | Department of Veterans Affairs, Primary Care, 100 Emancipation Lane, Hampton, VA 23667 | 2006-04-19 |
| 1013978451 | Donald Epstein | Psychologist | 1000 Emancipation Drive, Hampton, VA 23667 | 2006-03-28 |
| 1225098593 | Maryanne Schaeffer | Dietitian, Registered | 100 Emancipation Drive, Hampton, VA 23667 | 2006-03-23 |
| 1376074773 | Linda Carol Whitfield | Case Manager/Care Coordinator | 100 Emancipation Drive, Hampton, VA 23667 | 2017-03-27 |
| 1316217516 | Wallace Danny Johnson IIi | Occupational Therapist | 100 Emancipation Drive, Hampton, VA 23667 | 2012-01-04 |
| 1386929164 | Amber Mizuki | Dietitian, Registered | 100 Emancipation Drive, Bldg 116, Hampton, VA 23667 | 2011-10-12 |
| 1447549266 | Irene Nanghui Yi | Pharmacist | 100 Emancipation Dr., Hampton Vamc, Hampton, VA 23667 | 2011-04-01 |
| Find all providers in zip 23667 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123107 | Jessica Lynn Gray I | Social Worker | 77 Wall St, Hampton, GA 30228-2000 | 2020-04-17 |
| 1649807132 | Brandee Parker | Social Worker | 260 Marcella Rd Apt 1014, Hampton, VA 23666-2591 | 2020-03-24 |
| 1346875036 | Jalanda Monannique Jordan | Social Worker | 604 Burtons Cv, Hampton, GA 30228-3182 | 2020-03-03 |
| 1861025645 | Patti Jo Hammonds-greene | Social Worker | 11514 Summer Trce, Hampton, GA 30228-2694 | 2020-02-19 |
| 1780221242 | Mylira Jervette Green | Social Worker | 2019 Cunningham Dr Ste 412, Hampton, VA 23666-3318 | 2019-12-04 |
| 1598300857 | Lisa Marie Martin | Social Worker | 1720 N King St, Hampton, VA 23669-1910 | 2019-11-11 |
| 1013559418 | Carin Danielle Hamilton | Social Worker | 2019 Cunningham Dr Ste 301, Hampton, VA 23666-3318 | 2019-10-17 |
| 1326696972 | Shonda Mcfield | Social Worker | 4 Valor Pl, Hampton, VA 23669-2887 | 2019-08-27 |
| 1649740572 | Leap Therapeutic Services | Social Worker | 2110 Hartford Rd Ste B, Hampton, VA 23666-6600 | 2018-12-04 |
| 1528537271 | Jamicia Lanece Davis | Social Worker | 1706 Todds Ln, Hampton, VA 23666-3123 | 2018-11-23 |
| Find all providers in HAMPTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.