Elizabeth Clark

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

992361 Issued in CO

Practice address

3035 W 25TH Ave
Denver, CO 80211-4635

Phone

(303) 455-2409

NPI assigned

Jul 11, 2015

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

Enrolled in CO

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shine Fitness LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1639553944
  Medicare reassignment NPD Authorized official
• Shine Fitness

  • Clinical Social Worker
  • Denver, CO
  • NPI 1841678836
  NPD (past) Authorized official

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

{
    "created_epoch": "1436572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436572800000",
    "number": "1083098842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 WOLFF ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802121521",
            "telephone_number": "303-455-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 W 25TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802114635",
            "telephone_number": "303-455-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-11",
        "last_updated": "2015-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine E Clark, NP
• Cheryl Ann Clark, M.D.
• Corine Clark, PMHNP-BC
• Cynthia Clark, MS OTR BCP
• Elisa Ann Clark, LPC
• Elizabeth Clark, OT
• Emily Clark, M.A.
• Gwendolyn Marie Clark
• Indya Joi Clark
• Jennifer Jocelyn Clark, MD

• Clinical Social Worker in Denver, CO
• Providers in Denver, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.