John D Clark, MSW, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

04054 Issued in MD

Practice address

10905 Fort Washington Rd
Fort Washington, MD 20744-5843

Phone

(301) 292-3994

Fax

(301) 292-4928

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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)

Enrolled

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.

• New Horizons Psychological Services LLC

  • Clinical Child & Adolescent Psychologist
  • Fort Washington, MD
  • NPI 1053403386
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306861331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 WABASH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157436",
            "telephone_number": "410-367-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 FORT WASHINGTON RD",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445843",
            "telephone_number": "301-292-3994",
            "fax_number": "301-292-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MSW, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "04054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children's Dental Carousel Inc
• Chilo Obianwu DMD. All Smiles Dental Care P.C
• Onyinye Chime
• Anna Elisabetta Chirighin, M.A., BCBA
• Eileen Chong, PA-C
• Dascha Cleckley
• Coates Empowerment LLC
• Fatima Cochran, LCPC
• Kristin Cokley
• Haja Z Cole

• Clinical Social Worker in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.