Roberta Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5727 Issued in FL

Practice address

1100 N Pine St
Clearwater, FL 33756-4104

Phone

(727) 442-7106

NPI assigned

Aug 16, 2017

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

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, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cotler Healthcare and Development IncGroup PAC ID 0143121145, 25 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.

• Cotler Healthcare & Development Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellington, FL
  • NPI 1225075047
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1144746702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 DUNCAN LOOP S # 4-101",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346981307",
            "telephone_number": "727-480-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PINE ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564104",
            "telephone_number": "727-442-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERTA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "SW5727",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Joseph Clare
• Charlene Clark
• Christine Marie Clark
• Myrtle McGregor Clark
• Randall Clark, LMT, CINT
• Shannon Wayne Clark, RPH
• Reinaldo Claudio, D.M.D., M.D.
• Dylan O Clausen, DC
• Matthew Clavenna, MD
• Alexander Maximo Clavijo, MD

• Clinical Social Worker in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.