KELLY CLARK (NPI# 1881715068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881715068 |
| Entity Type | Individual |
| Full Name | KELLY CLARK |
| Credential | LICSW |
| Practice Address |
425 Prospect St Northampton MA 01060-2046 |
| Practice Telephone | 4137272640 |
| Mailing Telephone | 4137272640 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2019-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MBHP | 0300010 | 01 |
| MA | 1300881 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026650 | Kelly Ann Clark | Nurse Practitioner | 4590 Childrens Pl, Saint Louis, MO 63110-1020 | 2020-03-02 |
| 1013474410 | Kelly Patricia Clark | Licensed Practical Nurse | 55 Pine Dr E, Mason, MI 48854-9229 | 2019-02-22 |
| 1013497304 | Kelly Ann Clark | Case Manager/Care Coordinator | 2498 Wenona Dr, Wixom, MI 48393-2199 | 2018-08-16 |
| 1407336720 | Kelly Elizabeth Clark | Physical Medicine & Rehabilitation | 3800 Reservoir Rd., Bles Building, Ground Floor, Department of Pm&r, Washington, DC 20007-2113 | 2018-08-16 |
| 1356747448 | Kelly Clark | Dietitian, Registered | 46 Mallards Cv, Duxbury, MA 02332-3548 | 2014-11-17 |
| 1568883312 | Kelly Clark | Licensed Practical Nurse | 125 W Bartlette St, Apt. 110, Sumter, SC 29150-5173 | 2013-12-20 |
| 1306105903 | Kelly Thomas Clark | Speech-Language Pathologist | 3406 Fowler Ct, Missouri City, TX 77459-6366 | 2012-05-16 |
| 1619247509 | Kelly Jane Clark | Pharmacist | 328 Quail Walk Trl, Chapin, SC 29036-9791 | 2012-01-09 |
| 1427350461 | Kelly Darlene Clark | Chiropractor | 2425 Mahan Dr, Tallahassee, FL 32308-2301 | 2010-11-24 |
| 1538479324 | Kelly S Clark | Licensed Vocational Nurse | 15716 W High St # 597, Middlefield, OH 44062-9201 | 2010-10-14 |
| Street Address |
425 PROSPECT ST |
| City | NORTHAMPTON |
| State | MA |
| Zip Code | 01060-2046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942869318 | Stephanie Jordan | Counselor | 16 Center St Ste 517, Northampton, MA 01060 | 2019-06-10 |
| 1659853828 | James Drisko | Social Worker | 159 Crescent St, Northampton, MA 01060 | 2018-09-04 |
| 1063994416 | Nancy P Doby | Social Worker | 84 Conz Street, Northampton, MA 01060 | 2018-09-02 |
| 1356821144 | Kathleen Ann Goodwin-boyd | Social Worker | Northampton High School, 380 Elm Street, Northampton, MA 01060 | 2018-08-21 |
| 1457847048 | Kathryn Karusaitis Basham | Social Worker | 155 Main Street C/o Dr. Herzog Phd, Northampton, MA 01060 | 2018-07-06 |
| 1700392289 | Angel Marie Kennedy | Behavioral Analyst | 351 Pleasant St Ste B126, Northampton, MA 01060 | 2017-12-20 |
| 1013437508 | Ricky Jermaine Logan | Counselor | 129 North King Street, Northampton, MA 01060 | 2017-06-26 |
| 1962858886 | Alicia Simoni | Social Worker | 25 Main St Ste 445, Northampton, MA 01060 | 2016-05-10 |
| 1134589708 | James Edmonstone | Clinic/Center | 78 Mainst., Suite 404, Northampton, MA 01060 | 2016-02-25 |
| 1114395639 | Danielle Baker | Speech-Language Pathologist | 228 King St Ste 2, Northampton, MA 01060 | 2015-09-15 |
| Find all providers in zip 01060 | ||||
| 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 |
|---|---|---|---|---|
| 1790310555 | Leah Berkowitz-gosselin | Social Worker | 16 Center St Ste 316, Northampton, MA 01060-3031 | 2020-03-11 |
| 1417412396 | James Lowell Ferry | Social Worker | 94 King St Ste A, Northampton, MA 01060-3284 | 2019-02-05 |
| 1598240764 | Brittany Billmeyer-finn | Social Worker | 25 Main St Ste 313, Northampton, MA 01060-3109 | 2018-10-03 |
| 1578047148 | Mary Stout Reynolds | Social Worker | 39 Main St Ste 31, Northampton, MA 01060-3578 | 2018-09-19 |
| 1427531136 | Barbara Tytell | Social Worker | 99 Massasoit St, Northampton, MA 01060-2017 | 2018-09-09 |
| 1659853828 | James Drisko | Social Worker | 159 Crescent St, Northampton, MA 01060 | 2018-09-04 |
| 1063994416 | Nancy P Doby | Social Worker | 84 Conz Street, Northampton, MA 01060 | 2018-09-02 |
| 1508348137 | Margaret M Oneill | Social Worker | 64 Kensington Avenue, Northampton, MA 01060-2920 | 2018-08-30 |
| 1457847048 | Kathryn Karusaitis Basham | Social Worker | 155 Main Street C/o Dr. Herzog Phd, Northampton, MA 01060 | 2018-07-06 |
| 1619494523 | Carey Morgan | Social Worker | 300 Pleasant St Ste 1, Northampton, MA 01060-3917 | 2017-08-23 |
| Find all providers in NORTHAMPTON | ||||
| City | NORTHAMPTON |
| Zip Code | 01060 |
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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.