Jane Marie Clark, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

088842 Issued in NY

Practice address

1427 Genesee St
Utica, NY 13501-4343

Phone

(315) 738-1428

Fax

(315) 733-7105

NPI assigned

Aug 22, 2013

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

Other identifiers 1

Other names 1

• Jane Marie Shelnutt Former name

Medicare fee-for-service enrollment

Enrolled in NY

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, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Come to the Table Counseling LCSW 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Come to the Table Counseling LCSW

  • Clinical Social Worker
  • Camden, NY
  • NPI 1093319576

  NY

  Medicare reassignment Care Compare group NPD
• Upstate Cerebral Palsy, Inc

  • Mental Health Counselor
  • Utica, NY
  • NPI 1780636506

  NY

  Medicare reassignment NPD
• Upstate Cerebral Palsy, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Utica, NY
  • NPI 1215098207
  NPD

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1124452537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014343",
            "telephone_number": "315-738-1428",
            "fax_number": "315-733-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014343",
            "telephone_number": "315-738-1428",
            "fax_number": "315-733-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANE",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-22",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215098207",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "SHELNUTT",
            "middle_name": "MARIE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Cittadino
• City of Utica
• Dexter Clark
• Elizabeth M Clark, LCSW
• Eric Lynell Clark, RPA-C
• Colleen Clemons
• Climb Chiropractic, PLLC
• Delana Marie Clive
• Emily Closinski, MSED
• Kimberly Koziarz Clough, PHARM D

• All providers in Utica, NY
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.