DR. JERRY LEE CLARK (NPI# 1881911261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881911261 |
| Entity Type | Individual |
| Full Name | DR. JERRY LEE CLARK |
| Credential | PH.D., MSW |
| Practice Address |
201 W Broadway St Suite A North Little Rock AR 72114-5552 |
| Practice Telephone | 5013246395 |
| Mailing Telephone | 5013246395 |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2010-04-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
01232 | IA | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801015825 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548664766 | Jerry Kent Clark Jr. | Audiologist | 4611 Otter Ct, Burlington, NC 27215-9076 | 2014-10-17 |
| 1447490792 | Jerry W Clark | Counselor | 470 Bannon St, Sacramento, CA 95811-0204 | 2009-02-26 |
| 1114082872 | Jerry S Clark | Chiropractor | 3325 N University Ave Ste 125, Provo, UT 84604-6615 | 2006-12-23 |
| 1710058284 | Jerry D Clark | Counselor | 1830 Nasa Pkwy Ste 104, Houston, TX 77058-3544 | 2006-11-13 |
| 1639187297 | Jerry Christopher Clark | Massage Therapist | 2360 S Union Ave, Alliance, OH 44601-5079 | 2006-08-03 |
| 1710465919 | Jerry Clark | Behavioral Analyst | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2018-07-31 |
| 1497232060 | Jerry Dean Clark | Counselor | 1616 S Gold St Ste 4, Centralia, WA 98531-8930 | 2018-07-25 |
| 1619203551 | Jerry R Clark | Dentist | 1115 W Friendly Ave, Greensboro, NC 27401-1844 | 2009-10-28 |
| 1356521371 | Jerry Lee Clark | Counselor | 112 N Broad St, Rm 821, Phila, PA 19102-1510 | 2007-11-07 |
| 1346280005 | Jerry A Clark | Internal Medicine | 722 N Fairfield Rd, Beavercreek, OH 45434-5918 | 2006-06-08 |
| Street Address |
201 W BROADWAY ST SUITE A |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72114-5552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144461500 | Central Arkansas Disability Services | Day Training, Developmentally Disabled Services | 201 W Broadway St, Suite M, North Little Rock, AR 72114-5552 | 2009-03-16 |
| 1417139049 | Monique Ann Myers | Social Worker | 201 W Broadway St, North Little Rock, AR 72114-5552 | 2007-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316432966 | Mid State Counseling and Recovery Service | Clinic/Center | 1920 Main St Ste 229, North Little Rock, AR 72114 | 2018-06-26 |
| 1053826842 | Kelli Lauron Johnson | Nurse Practitioner | 2800 North Willow Street, North Little Rock, AR 72114 | 2017-12-03 |
| 1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
| 1366787459 | J Andrew Mccullough | Counselor | 628 W Broadway St Ste 300, North Little Rock, AR 72114 | 2012-11-30 |
| 1598071490 | Roger Elliott Hicks IIi | Counselor | 2200 Fort Roots Dr # 3d, North Little Rock, AR 72114 | 2010-08-30 |
| 1740594456 | Tuyet Thi Van | Dentist | 520 W. Pershing Blvd., North Little Rock, AR 72114 | 2010-08-05 |
| 1467764183 | Jennifer Leigh Nash | Behavioral Analyst | 628 W Broadway St Ste 100, North Little Rock, AR 72114 | 2010-07-10 |
| 1336398544 | Tina A Davie | Registered Nurse | 2200 Foot Roots Drive, Little Rock, AR 72114 | 2008-09-11 |
| 1316125313 | Centers for Youth & Families | Community/Behavioral Health | 200 W. 20th, North Little Rock, AR 72114 | 2008-02-01 |
| 1881878064 | Marie A Graham | Nurse Practitioner | 636 West Broadway St, No Little Rock, AR 72114 | 2007-12-24 |
| Find all providers in zip 72114 | ||||
| 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 |
|---|---|---|---|---|
| 1194254631 | Emily Marie Bass | Social Worker | 4701 Fairway Ave Ste B, North Little Rock, AR 72116-8069 | 2017-06-08 |
| 1992127419 | Mccain Psychotherapy Center | Social Worker | 3805 Mccain Park Dr Ste 116, North Little Rock, AR 72116-7813 | 2014-01-17 |
| 1811285620 | Jentry Edward Tillman | Social Worker | Camp Joseph T Robinson, North Little Rock, AR 72199-0001 | 2011-07-13 |
| 1043521370 | Amy Smith Freer | Social Worker | 425 W Broadway St Ste D, North Little Rock, AR 72114-5576 | 2010-07-01 |
| 1659603397 | Mackenzi T. Davis | Social Worker | 4702 W Commercial Dr Ste B3, North Little Rock, AR 72116-7073 | 2010-02-05 |
| 1720312283 | Michael James Casillas | Social Worker | 4260 Stockton Dr, Suite A, North Little Rock, AR 72117-2915 | 2009-09-30 |
| 1487886255 | Chelsie M Hall | Social Worker | 12412 Faulkner Crossing Dr, North Little Rock, AR 72117-9793 | 2009-08-12 |
| 1578713277 | Robert Earl Pruitt Jr. | Social Worker | 2200 Fort Root Dr., North Little Rock, AR 72206 | 2008-09-30 |
| 1649427170 | Byron W Scheider | Social Worker | 7609 Tomahawk Dr, North Little Rock, AR 72116-4338 | 2008-08-27 |
| 1154442341 | Angela A Smith | Social Worker | 1900 North Pine Street, North Little Rock, AR 72114 | 2007-04-03 |
| Find all providers in NORTH LITTLE ROCK | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72114 |
Please comment or provide details below to improve the information on DR. JERRY LEE CLARK.
| 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.