Carolyn Clark, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC200001366 Issued in DC

Practice address

3251 Mount Pleasant St NW FL 3
Washington, DC 20010-2103

Phone

(571) 308-8217

NPI assigned

Jan 29, 2020

Last updated

Mar 16, 2023By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1215568118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3251 MOUNT PLEASANT ST NW FL 3",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 MOUNT PLEASANT ST NW FL 3",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102103",
            "telephone_number": "571-308-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAROLYN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG50082969",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cclark@some.org",
            "affiliation": "N",
            "endpointDescription": "work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "60 O St NW",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200011259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ayanah Clark
• Barbara Clark
• Barry Paul Clark, MD
• Beyonka Clark
• Bronwyn Dalton Clark, L.AC., M.AC., DIPLAC
• Charles H Clark Jr., M.D.
• Christopher Clark
• Crystal Sherase Clark
• Curtis Anthony Clark III
• Cynthia Clark, RD

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.