David Burton Clark Jr., LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

3170 W Central Ave Ste B
Toledo, OH 43606-2945

Phone

(567) 316-7353

NPI assigned

Sep 10, 2019

Sex

Male

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

Enrolled in OH

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

University of Arkansas College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Talbot Clinical Services of Ohio LLCGroup PAC ID 9032422860, 11 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.

• Talbot Clinical Services of Ohio LLC

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1053902007
  Medicare reassignment Care Compare group NPD
• Talbot Clinical Services of Ohio LLC

  • Professional Counselor
  • Toledo, OH
  • NPI 1245635549
  Medicare reassignment
• Talbot Clinical Services of Ohio LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mount Washington, KY
  • NPI 1316646722
  NPD

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1164071338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 W CENTRAL AVE STE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436062945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3170 W CENTRAL AVE STE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436062945",
            "telephone_number": "567-316-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "BURTON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Suzanne Clark, PHARMD
• Aubrey Lynn Clark
• Brooke Marie Clark
• Cassandra Clark
• Dashawn Clark
• Demenica Clark
• Demetria Clark
• Denise Lynn Clark
• Devore Clark Sr., QBHS
• Hope E Clark, BSW

• Social Worker in Toledo, OH
• Providers in Toledo, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.