Elisabeth Anna Muldowney Clyde, LAC, R-DMT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

37AC00709000 Issued in NJ

Practice address

311 Market St
Camden, NJ 08102-1523

Phone

(856) 963-5668

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1124723903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 ATLANTIC AVE APT B",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083162",
            "telephone_number": "484-202-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MARKET ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021523",
            "telephone_number": "856-963-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "ELISABETH",
        "middle_name": "ANNA MULDOWNEY",
        "credential": "LAC, R-DMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "NJ",
            "license": "2711",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00709000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah G. Clarke, D.O.
• Christina M Clay, M.D.
• David H. Clements, MD
• Marilyn Miranda Clifford, APN
• Giovonna R Clifton, CD
• CMC Department of Medcine
• CMC Department of Medicine
• CMC Department of Medicine
• CMC Department of Medicine
• CMC Department of Medicine

• Counselor in Camden, NJ
• Providers in Camden, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.