Edward J Clark, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2649 Issued in MA

Practice address

175 Franklin St
North Adams, MA 01247-2712

Phone

(413) 664-4401

NPI assigned

Mar 23, 2007

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)

Not enrolled

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316064777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 PLEASANT ST",
            "city": "DALTON",
            "state": "MA",
            "postal_code": "012261137",
            "telephone_number": "413-684-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FRANKLIN ST",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472712",
            "telephone_number": "413-664-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "2649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jenny Citrin, DMD
• Jennifer Rancourt Civello, MA CTTS
• Joanne Clark
• Jonathan C Cluett, MD
• Collaborative Counseling, LLC
• Richard Collins, LMHC
• Community Health Programs

• Occupational Therapy Assistant in North Adams, MA
• Providers in North Adams, MA by specialty
• Occupational Therapy Assistant in Massachusetts

• 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.