Kassie Jo Lovely Clark, MS,OT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

TO2657 Issued in ME

Practice address

79 Blake St
Suite 1
Presque Isle, ME 04769-2474

Phone

(207) 764-3036

NPI assigned

Aug 10, 2012

Last updated

Aug 17, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• The County OT, LLC

  • Occupational Therapist
  • Mapleton, ME
  • NPI 1255059200
  NPD Authorized official
• Msad01

  • Local Education Agency (LEA)
  • Presque Isle, ME
  • NPI 1639383409
  NPD (past)
• Msad1

  • Developmentally Disabled Services Day Training Agency
  • Presque Isle, ME
  • NPI 1275744740
  NPD (past)

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1154678969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 GRIFFIN RIDGE RD",
            "city": "MAPLETON",
            "state": "ME",
            "postal_code": "047574415",
            "telephone_number": "207-227-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BLAKE ST",
            "address_2": "SUITE 1",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692474",
            "telephone_number": "207-764-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELY CLARK",
        "first_name": "KASSIE",
        "middle_name": "JO",
        "credential": "MS,OT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "TO2657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grady Lewin, BOCP, CFO
• Life by Design, PA
• Lionheart Health PLLC (Lionheart DPC)
• Alexandra Lord
• Rose Marie Cyr Louten, MS RD LD
• James M. Lovely, MHRT-CSP
• Christian Blake Lunn, ATC
• Eric A Macek
• Julia R Macek, LCSW
• Thomas Chege Macharia, MD

• Occupational Therapist in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.