NPIMap

Organization Active NPI

Psychotherapy & Organizational Development LLC

Doing business as Carlton F 'Perk' Clark, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1205856101
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-0011 Issued in AZ
Legal business name
PSYCHOTHERAPY & ORGANIZATIONAL DEVELOPMENT LLC
Doing business as
Carlton F 'Perk' Clark, LCSW
Practice address
350 S Williams Blvd
Ste 140
Tucson, AZ 85711-7416
Phone
(520) 519-8475
Fax
(520) 519-8476
NPI assigned
Jul 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Carlton Frederic Clark, LCSWNPI 1487415501
Title
Owner
Phone
(520) 519-8475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCSW-0011 AZ Primary

Addresses

Primary practice location

350 S Williams Blvd
Ste 140
Tucson, AZ 85711-7416

Mailing address

350 S Williams Blvd
Ste 140
Tucson, AZ 85711-7416
Phone (520) 519-8475

Other names 1

  • Carlton F 'Perk' Clark, LCSW Doing business as

National Provider Directory

National Provider Directory

Locations

350 S Williams Blvd
Ste 140
Tucson, AZ 85711
Phone (520) 519-8475

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205856101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S WILLIAMS BLVD",
            "address_2": "STE 140",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857117416",
            "telephone_number": "520-519-8475",
            "fax_number": "520-519-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S WILLIAMS BLVD",
            "address_2": "STE 140",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857117416",
            "telephone_number": "520-519-8475",
            "fax_number": "520-519-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPY & ORGANIZATIONAL DEVELOPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "FREDERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-519-8475",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-0011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlton F 'Perk' Clark, LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.