Cara A Clark

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F406155-01 Issued in NY

Practice address

Summit School Nyack
339 North Broadway
Upper Nyack, NY 10960

Phone

(845) 358-7772

Fax

(845) 358-0561

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Summit Childrens Residence Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Nyack, NY
  • NPI 1043766595
  NPD (past)
• Summit School

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Nyack, NY
  • NPI 1558536649
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1043983869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SALMAR AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651322",
            "telephone_number": "914-261-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUMMIT SCHOOL NYACK",
            "address_2": "339 NORTH BROADWAY",
            "city": "UPPER NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-358-7772",
            "fax_number": "845-358-0561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Rockland BOCES",
            "address_2": "65 Parrott Rd",
            "address_purpose": "LOCATION",
            "city": "West Nyack",
            "state": "NY",
            "postal_code": "10994",
            "country_code": "US",
            "telephone_number": "845-627-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "706 Executive Blvd",
            "address_purpose": "LOCATION",
            "city": "Valley Cottage",
            "state": "NY",
            "postal_code": "109892038",
            "country_code": "US",
            "telephone_number": "845-362-3904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CARA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "473158-1",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "473158-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406155-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Lewis Baker, LCSW
• Simona Chazen, MSW LCSW
• Karen Rose Hebert, PHD
• Gail Lovejoy, LCSW
• Gina Trolio, M.A.

• Psychiatric/Mental Health Nurse Practitioner in Upper Nyack, NY
• Providers in Upper Nyack, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.