Owen Clark

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

235 E Ponce de Leon Ave Ste 320
Decatur, GA 30030-3452

Phone

(404) 692-2932

NPI assigned

May 15, 2024

Last updated

May 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grounded Wellbeing

  • Clinical Social Worker
  • Decatur, GA
  • NPI 1326720798
  NPD
• Meristem Therapy Services, LLC

  • Clinical Social Worker
  • Athens, GA
  • NPI 1992548176
  NPD (past)

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1366291940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 APPLEBY DR APT 216",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306055411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E PONCE DE LEON AVE STE 320",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303452",
            "telephone_number": "404-692-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "OWEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lena G Clark
• Mary Clark, MSW
• Mary Katherine Clark, PA-C
• Neal Clark, ARRT
• Omeka Clark, PHARM.D.
• Ross Jameson Clark, NP-C
• Sharronda Renee Clark, FNP
• Tamika Tashell Clark, LPC
• Alexis Clarke, BACHELOR OF SCIENCE
• Sakinah Clarke

• Clinical Social Worker in Decatur, GA
• Providers in Decatur, 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 May 24, 2024; 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.