Lauren E Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3155 Mill St NE
Covington, GA 30014-2542

Phone

(678) 712-6520

Fax

(678) 712-6521

NPI assigned

Jul 22, 2019

Sex

Female

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeastern Psychological Associates, Inc

  • Clinical Child & Adolescent Psychologist
  • Covington, GA
  • NPI 1316216880
  NPD

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1356994032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 MILL ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142542",
            "telephone_number": "678-712-6520",
            "fax_number": "678-712-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 MILL ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142542",
            "telephone_number": "678-712-6520",
            "fax_number": "678-712-6521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "778 Funderburg Dr",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "GA",
            "postal_code": "310641447",
            "country_code": "US",
            "telephone_number": "678-712-6520",
            "fax_number": "678-712-6521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LAUREN",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raynecia Chisolm, RN
• Kimberly Allison Chitwood, FNP
• Choice Medical
• Brantriesa Clark, PA
• Kimberly Clark
• Michelle J Clark, DR.
• Cleansparrow LLC
• Kelly King Cleary, OD
• Lynwood Paul Cleaveland, M.D.
• Martha Clements

• Clinical Social Worker in Covington, GA
• Providers in Covington, 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 Jul 22, 2019; 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.