Renee Clark

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2795 Main St W Ste 20B
Snellville, GA 30078-3073

Phone

(678) 344-7836

Fax

(678) 892-8575

NPI assigned

Mar 29, 2017

Last updated

Mar 29, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1184156143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CRUSADER PL",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134339",
            "telephone_number": "404-449-3121",
            "fax_number": "678-892-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 MAIN ST W STE 20B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783073",
            "telephone_number": "678-344-7836",
            "fax_number": "678-892-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Litchfield Chubbuck, LPC, LISW
• Constance Chukwuka, RD
• CJC Health Solutions, LLC
• Clark Counseling & Consulting, Inc.
• Aletha Jennifer Clark, PHD, LPC
• Sandra Clark, L.C.S.W.
• Sarah Clark, RBT
• Will Clark, MS, APC, NCC
• Sonji Clarke-Allen
• Damaris Claudio, LCSW

• Clinical Social Worker in Snellville, GA
• Providers in Snellville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.