Active NPI
Paul E Clark, MSW
- Social Worker
- Norwich, CT
National Provider Identifier
1083051684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 47 Town St
Norwich, CT 06360-2315 - Phone
- (860) 892-7042
- NPI assigned
- May 23, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
47 Town St
Norwich, CT 06360-2315
Mailing address
47 Town St
Norwich, CT 06360-2315
Phone (203) 206-8434
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8974 | CT | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1083051684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 TOWN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602315",
"telephone_number": "203-206-8434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 TOWN ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602315",
"telephone_number": "860-892-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "PAUL",
"middle_name": "E",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-23",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norwich, CT
- Joanna Oszmian Cirigliano, LMFT
- City of Norwich Board of Education
- City of Norwich-Norwich Youth and Family Services
- Donna M Civardi, RNFA, APRN, FNP-BC
- Christina Clarino, LPC
- Ashley Diogo Cleary, LMFT
- Climb the Mountain Counseling Services
- CLL Health Care Clinic, LLC
- Novyanna Airel Coates
- Janet Cohen
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.