Keri Clark, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05867 Issued in IA

Practice address

6165 NW 86TH St Ste 200
Johnston, IA 50131-2270

Phone

(515) 316-9720

NPI assigned

Oct 17, 2006

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)

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.

• Counseling Insights, LLC

  • Clinical Social Worker
  • Johnston, IA
  • NPI 1114544350

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1376624650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 NW 86TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312270",
            "telephone_number": "515-316-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6165 NW 86TH ST STE 200",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312270",
            "telephone_number": "515-316-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KERI",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "05867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Johnston
• Laurie Lavon Clair, MSPA, PA-C
• Alicia Cathleen Clancy, MOT, OTR/L
• Clarity Chiropractic LLC
• Katherine Lee Clark, M.A.
• Nicholas Clark
• Kevin Clough
• Nathaniel Cobb
• Comfort Residential Care LLC
• Community Outreach Services, LLC

• All providers in Johnston, IA
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.