Active NPI
Sheena Tooley Clark, LCSW
- Clinical Social Worker
- Winter Park, FL
National Provider Identifier
1083153662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW12871
- Practice address
- 1933 Dundee Dr
Winter Park, FL 32792-4103 - Phone
- (407) 622-2647
- Fax
- (407) 644-3058
- NPI assigned
- Feb 16, 2017
- Last updated
- Feb 16, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW12871 | FL | Primary |
Addresses
Primary practice location
1933 Dundee Dr
Winter Park, FL 32792-4103
Mailing address
1933 Dundee Dr
Winter Park, FL 32792-4103
Phone (407) 622-2647
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW12871 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1083153662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 DUNDEE DR",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924103",
"telephone_number": "407-622-2647",
"fax_number": "407-644-3058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1933 DUNDEE DR",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924103",
"telephone_number": "407-622-2647",
"fax_number": "407-644-3058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SHEENA",
"middle_name": "TOOLEY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-16",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW12871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.