Ellen Clark

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4213 Corby St
Omaha, NE 68111-3454

Phone

(402) 980-6637

NPI assigned

Mar 14, 2025

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1083414569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 S 48TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063215",
            "telephone_number": "402-980-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 CORBY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681113454",
            "telephone_number": "402-980-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J Clark
• Devan Clark, CCC-SLP
• Devynn Clark
• Donesha Marquette Clark
• Doris Clark
• Enaysia Clark
• Enniya Clark
• Eric B Clark Jr.
• Ethel Grace Dalmacio Clark
• Frances Lue Clark, LPN

• Behavior Technician in Omaha, NE
• Providers in Omaha, NE by specialty
• Behavior Technician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.