David Clark, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801002738 Issued in MI

Practice address

980 Keaton Dr
Troy, MI 48098-1861

Phone

(248) 879-1277

Fax

(248) 250-6919

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• David Wesley Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1073611448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 KEATON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480981861",
            "telephone_number": "248-879-1277",
            "fax_number": "248-250-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 KEATON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480981861",
            "telephone_number": "248-879-1277",
            "fax_number": "248-250-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801002738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "CLARK",
            "middle_name": "WESLEY",
            "credential": "MSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jerome V Ciullo, MD
• Abigail Jane Cizek, PA-C
• David Claeys
• Gary Jonathan Clague, DDS
• Margo Rose Clarfelt
• Elizabeth Clark
• Emily K Clark
• Gina Clark
• Thomas Allen Clark, PT
• James N. Clarke, RPH

• Clinical Social Worker in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.