Monica Mary Clark, MSW LISW LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0821 Issued in IA

Practice address

2102 East 38TH St
Davenport, IA 52807

Phone

(563) 359-4049

Fax

(563) 359-4069

NPI assigned

Feb 17, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1376517045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 EAST 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52807",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 EAST 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52807",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MONICA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "MSW LISW LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "0821",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "16",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1108750000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Family Vision PLC
• Chamein K Clark Witter, DCPC
• Cathleen Ann Clark, LICSW
• Katherine Louise Clark, D.C.
• Madison Linn Clark, LSW
• Tara Clark
• Frank Reginald Claudy, MD
• Natalie Clausen-Meyers
• Kasia Anna Claussen, PT, DPT
• Mackenzie S Clawson, DMD

• Clinical Social Worker in Davenport, IA
• Providers in Davenport, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.