Individual provider Active NPI

Molly Beth Clarke, LCSW, LCADC

  • Clinical Social Worker
  • Egg Harbor Township, NJ
National Provider Identifier
1407307903
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05771300 Issued in NJ
Practice address
2600 Tilton Rd # 1014
Egg Harbor Township, NJ 08234-1831
Phone
(732) 546-5422
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00306600 NJ
Clinical Social Worker 1041C0700X 44SC05771300 NJ Primary

Addresses

Primary practice location

2600 Tilton Rd # 1014
Egg Harbor Township, NJ 08234-1831

Mailing address

2600 Tilton Rd # 1014
Egg Harbor Township, NJ 08234-1831
Phone (732) 546-5422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20180313000738 NJ Practitioner - Clinical Social Worker 4789946617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocean Health Initiatives, IncGroup PAC ID 2062405277, 27 clinicians

Practice addresses (Care Compare)

101 2ND St
Lakewood, NJ 08701-3324
Phone (732) 363-6655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00306600NJMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Health Initiatives Inc Social Worker Current Accepting new patients
Ocean Health Initiatives, Inc CurrentSince Dec 1, 2020 Accepting new patients
CPC Integrated Health, Inc. Current Accepting new patients
Ocean Health Initiatives,Inc CurrentSince Dec 1, 2020 Accepting new patients
Full Bloom Therapy Services LLC CurrentSince Feb 1, 2021 Accepting new patients
CPC Behavioral Healthcare, Inc CurrentSince Feb 13, 2018 Accepting new patients

Locations

10 Industrial Way E
Eatontown, NJ 07724
Phone (732) 935-2220

2600 Tilton Rd
#1014
Egg Harbor Twp, NJ 08234
Phone (609) 549-2504

22 Court St
Freehold, NJ 07728
Phone (732) 780-7387

101 2nd St
Lakewood, NJ 08701
Phone (732) 886-4809

1088 State Route 34
Matawan, NJ 07747
Phone (732) 290-1700

Interoperability endpoints

  • Direct secure messaging: molly.clarke.1@11915.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1407307903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TILTON RD # 1014",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082341831",
            "telephone_number": "732-546-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TILTON RD # 1014",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082341831",
            "telephone_number": "732-546-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MOLLY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00306600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05771300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

Verify at the official NPI Registry.