Keitrayana Yvette Clark, SWT

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

S.2604919-TRNE Issued in OH

Practice address

680 Park Ave W
Mansfield, OH 44906-3706

Phone

(419) 528-5993

Fax

(567) 560-5483

NPI assigned

Mar 5, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1407358682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706",
            "telephone_number": "419-528-5993",
            "fax_number": "567-560-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 PARK AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063706",
            "telephone_number": "419-528-5993",
            "fax_number": "567-560-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KEITRAYANA",
        "middle_name": "YVETTE",
        "credential": "SWT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OH",
            "license": "S.2604919-TRNE",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawna Rochelle Church, PT
• City Care Counseling Center
• City of Mansfield Ohio
• Christopher D Clark, P.T.
• Jessica S. Clark
• Lonna Marie Clark, LPN
• Niquita A. Clark
• Letitia Ann Clarke, LISW
• Clarkson Optometry Midwest Inc
• Maryssa Claytor

• School Social Worker in Mansfield, OH
• Providers in Mansfield, OH by specialty
• School Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.