Lyndsay Cogdill Clark, LICSW, PIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3783C Issued in AL

Practice address

636 Ridge Top Cir
Birmingham, AL 35206-1626

Phone

(863) 712-0765

NPI assigned

Nov 12, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1073115341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RIDGE TOP CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352061626",
            "telephone_number": "863-712-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RIDGE TOP CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352061626",
            "telephone_number": "863-712-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LYNDSAY",
        "middle_name": "COGDILL",
        "credential": "LICSW, PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3783C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Whiteside Clark, M.A., L.P.C.
• Kimberly Brooke Clark
• Kristina Clark, CRNP
• Leanna Grace Clark
• Lita A. Clark, PHD, LPC, SAP
• Madalyn Clark
• Manay Clark, O.D.
• Matthew Gill Clark, M.D.
• Melissa B Clark, OT
• Michael Dean Clark Jr.

• Clinical Social Worker in Birmingham, AL
• Providers in Birmingham, 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 May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.