David Clark, LICSW, MPH

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114456 Issued in MA

Practice address

780 Albany St
Boston, MA 02118-2755

Phone

(578) 654-1000

NPI assigned

Nov 30, 2006

Sex

Male

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Health Care for the Homeless Program, Inc.Group PAC ID 2668475419, 75 clinicians

Practice addresses (Care Compare)

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.

• Boston Health Care for the Homeless Program, Inc.

  • Federally Qualified Health Center (FQHC)
  • Boston, MA
  • NPI 1033157771
  Medicare reassignment Care Compare group NPD
• Boston Health Care for the Homeless Program, Inc.

  • Community/Retail Pharmacy
  • Boston, MA
  • NPI 1194443531
  NPD

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541808000000",
    "number": "1386712453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "578-654-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "578-654-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LICSW, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2018-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Joseph Clark
• Avery Emerson Clark
• Caitlin Clark, LCSW
• Catherine G Clark, PSYD
• Christopher S Clark, PA
• Devin Clark, MD
• Donna Marie Clark, NP
• Dylan Ross Clark, STUDENT
• Eric Delancey Clark
• Haley Ruth Clark, DO

• Clinical Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.