Sandra Ann Clark, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC3768 Issued in ME

Practice address

25 Old Ferry LN
Kittery, ME 03904-1305

Phone

(207) 439-5149

Fax

(207) 439-6001

NPI assigned

Jun 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Behavioral Healthcare, LLC

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1215102850
  NPD (past)
• Seacoast Counseling of Newburyport

  • Clinical Social Worker
  • Newburyport, MA
  • NPI 1245534908
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104862341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 OLD FERRY LN",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041305",
            "telephone_number": "207-439-5149",
            "fax_number": "207-439-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 OLD FERRY LN",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041305",
            "telephone_number": "207-439-5149",
            "fax_number": "207-439-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC3768",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "LICSW298",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1017961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark P Cartier, MD
• Donna Labrie Catalfo, OTR/L
• Ryan Erik Chessie, PT
• Margaret Julia Childress, PT, DPT
• Christian Counseling Associates, LLC
• Alyssa Jean Cole, PHARMD
• Conant Associates LLC
• Beverly Anne Conant, MA LPC LMFT
• Richard H Conant, LPC
• Richard T. Connelly, LCPC

• Clinical Social Worker in Kittery, ME
• Providers in Kittery, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.