Elizabeth Ellen Clark, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.2308966 Issued in OH

Practice address

419 Vernon St
Ironton, OH 45638-1637

Phone

(740) 357-8615

NPI assigned

Nov 3, 2021

Last updated

Jun 15, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Crossroads Treatment Center of Ashland, PSC

  dba Crossroads Treatment Center of Ashland

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ashland, KY
  • NPI 1346745718
  NPD (past)

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1366107518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131654",
            "telephone_number": "740-357-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 VERNON ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381637",
            "telephone_number": "740-357-8615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Greenup Ave",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "KY",
            "postal_code": "411017525",
            "country_code": "US",
            "telephone_number": "606-393-1165",
            "fax_number": "606-393-1775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZABETH",
        "middle_name": "ELLEN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2308966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Christian, RN
• Sandra Christian
• Erica D Chukwuemeka, RN
• Brian J Church, CDCA
• City of Ironton (Ironton city Health Department)
• Kelly S. Clark, LCDCII
• Mackenzie Clark
• Michael Wayne Clark
• Dafney Clary
• Dottie Clay

• Social Worker in Ironton, OH
• Providers in Ironton, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.