Active NPI
Caroline Clark Garden, LCSW
- Clinical Social Worker
- Yuma, AZ
National Provider Identifier
1033487376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW13143
- Practice address
- 11627 E 25TH St
Yuma, AZ 85367-2210 - Phone
- (850) 291-4714
- NPI assigned
- Dec 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW13143 | FL | Primary |
Addresses
Primary practice location
11627 E 25TH St
Yuma, AZ 85367-2210
Mailing address
11627 E 25TH St
Yuma, AZ 85367-2210
Phone (850) 291-4714
Other names 1
- Caroline Kelly Clark
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW13143 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Outreach, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687564800000",
"number": "1033487376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11627 E 25TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853672210",
"telephone_number": "850-291-4714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11627 E 25TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853672210",
"telephone_number": "850-291-4714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDEN",
"first_name": "CAROLINE",
"middle_name": "CLARK",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-01",
"last_updated": "2023-06-24",
"certification_date": "2023-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW13143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLINE",
"last_name": "CLARK",
"middle_name": "KELLY",
"credential": "P-LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.