Joan Leslie Clark, ED.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5635 Issued in FL

Practice address

3898 Via Poinciana Ste 17
Lake Worth, FL 33467-2951

Phone

(561) 613-1705

NPI assigned

Dec 28, 2018

Sex

Female

Sole proprietor

No

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": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1083186209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7379 SHELL RIDGE TERRACE",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677883",
            "telephone_number": "561-596-6670",
            "fax_number": "561-434-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 VIA POINCIANA STE 17",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672951",
            "telephone_number": "561-613-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOAN",
        "middle_name": "LESLIE",
        "name_prefix": "Ms.",
        "credential": "ED.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Cifelli, MA, CCC-SLP
• Jacy Cifuentes
• Stephana Cine Ulysse, NP
• Dennis Raymond Cirone, D.C.
• Donna Jean Clark Wrightman, RN
• Sana Clark, RN
• Teralea M Clark
• Desiree A Clarke, MD
• Relande Claude, RPH
• Clayton Supply Resources LLC

• Speech-Language Pathologist in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.