Susan Clark, CSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BP00945123 Issued in WV

Practice address

51 Street of Dreams
Martinsburg, WV 25403-1134

Phone

(304) 264-1442

NPI assigned

Apr 14, 2019

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

Enrolled in WV

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Eastern Panhandle Psychiatry IncGroup PAC ID 9931154176, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Eastern Panhandle Psychiatry, Inc

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1407930225
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1114580347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CLOUSER CT",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254057581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 STREET OF DREAMS",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254031134",
            "telephone_number": "304-264-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUSAN",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2019-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "BP00945123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D. Clark, L.P.C.
• Kathy Clark
• Kay R Clark, RN
• Ryan Gregory Clark, D.M.D.
• Stephanie Clark, BA
• Tamilyn Clark
• Keith B Clay
• Christine G Cleaves, CRNA
• Tina Marie Clemmons, PTA
• Katarina W Clingerman, PA-C

• Clinical Social Worker in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2019; 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.