PATRICK JEREMIAH CLARK (NPI# 1235313388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235313388 |
| Entity Type | Individual |
| Full Name | PATRICK JEREMIAH CLARK |
| Credential | MSW |
| Practice Address |
540 E First St Waconia MN 55387-1601 |
| Practice Telephone | 9524424437 |
| Practice Fax Number | 9524423084 |
| Mailing Telephone | 9524424437 |
| Mailing Fax Number | 9524422084 |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2007-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
16872LICSW | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTH PARTNERS | HP84895 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164048591 | Patrick Alan Clark | Optometrist | 202 N Mitchell St, Rio Grande City, TX 78582-2509 | 2020-06-22 |
| 1548668346 | Patrick Nikita Clark | Non-emergency Medical Transport (VAN) | 4281 Durango Ln, Memphis, TN 38109-4721 | 2014-12-09 |
| 1598751588 | Patrick A Clark | Family Medicine | 9631 269th St Nw, Stanwood, WA 98292-8071 | 2005-09-23 |
| 1770018459 | Patrick Clark | Behavior Technician | 4020 Folker St, Anchorage, AK 99508-5321 | 2017-05-01 |
| 1336508092 | Patrick J Clark | Dentist | 554 Kelly Street, Bumed, Attn: Credentialing & Privileging Directorate, Jacksonville, FL 32212 | 2016-02-23 |
| 1386941755 | Patrick Andrew Clark | Counselor | 9445 Farnham St, San Diego, CA 92123-1308 | 2011-02-22 |
| 1407036841 | Patrick W. Clark | Anesthesiology | 1800 Medical Center Pkwy, Suite 330, Murfreesboro, TN 37129-2567 | 2007-11-13 |
| 1972609436 | Patrick Timothy Clark | Physician Assistant | 4020 Us Highway 27 N, Sebring, FL 33870-1333 | 2006-09-15 |
| 1558301242 | Patrick Clark | Chiropractor | 1600 W 38th St, Suite 412, Austin, TX 78731-6407 | 2006-06-08 |
| 1285699553 | Patrick James Clark Jr. | Optometrist | 101 Bodin Cir, 60 Mdg/amds Optometry Clinic, Travis Afb, CA 94535-1809 | 2006-04-19 |
| Street Address |
540 E FIRST ST |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-1601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| 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 |
|---|---|---|---|---|
| 1275776361 | Jane Marie Fleming | Social Worker | 540 E. First St., Waconia, MN 55387-1601 | 2009-04-20 |
| 1023657863 | Sarah Manthei | Social Worker | 540 E 1st St, Waconia, MN 55387-1600 | 2019-12-26 |
| 1598223893 | Josie Hoffman | Social Worker | 540 E 1st St, Waconia, MN 55387-1600 | 2019-03-05 |
| 1518455096 | Alissa Menke | Social Worker | 201 W 1st St, Waconia, MN 55387-1302 | 2018-04-30 |
| 1467952986 | Alyson Montplaisir | Social Worker | 540 E 1st St, Waconia, MN 55387-1600 | 2018-02-21 |
| 1609384031 | Abby Therese Messer | Social Worker | 500 S Maple St, Waconia, MN 55387-1752 | 2018-01-19 |
| 1407364565 | Nicole Marcouiller | Social Worker | 500 S Maple St, Waconia, MN 55387-1752 | 2018-01-10 |
| 1174036297 | Emily Kruger | Social Worker | 540 E 1st St, Waconia, MN 55387-1600 | 2017-11-11 |
| 1992216188 | Michael Raguet | Social Worker | 540 E 1st St, Waconia, MN 55387-1600 | 2017-10-16 |
| 1033563184 | Kimberly Jo Hendrickson | Social Worker | 540 E 1st St, Waconia, MN 55387-1600 | 2016-04-14 |
| Find all providers in WACONIA | ||||
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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.