Christine M Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1757C Issued in AL

Practice address

38 Southmont Dr
Tuscaloosa, AL 35405-4162

Phone

(205) 614-0415

NPI assigned

Feb 28, 2020

Last updated

Feb 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama Therapy Center, PC

  • Clinical Social Worker
  • Tuscaloosa, AL
  • NPI 1598399776
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1063046068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 SOUTHMONT DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354054162",
            "telephone_number": "205-614-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 SOUTHMONT DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354054162",
            "telephone_number": "205-614-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1757C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Juliana Cia
• Javier Cintron, DO
• City of Tuscaloosa
• Anna Kathleen Clardy
• Clarity Counseling LLC
• Deidre Clark, PHARMD, BCPS
• Kelly Hopkins Clark, PHARMD
• Shacara Clark
• Jala A'Nia Clarke
• Clary & Jones LLC

• Clinical Social Worker in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.