Amy M Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW018061 Issued in PA

Practice address

130 Bridge St
Tunkhannock, PA 18657-1354

Phone

(570) 575-2468

Fax

(570) 836-0660

NPI assigned

Nov 9, 2010

Sex

Female

Sole proprietor

Yes

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 PA

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Amy M Clark LCSW & Associates LLC

  • Clinical Social Worker
  • Tunkhannock, PA
  • NPI 1760853774
  Medicare reassignment Authorized official
• Change of Heart Counseling and Consultation Services, Inc

  • Clinical Social Worker
  • Tunkhannock, PA
  • NPI 1619468097
  NPD

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1497056311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BRIDGE ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571354",
            "telephone_number": "570-575-2468",
            "fax_number": "570-836-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BRIDGE ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571354",
            "telephone_number": "570-575-2468",
            "fax_number": "570-836-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Change of Heart Counseling and Consultation Services, Inc
• Cheryl a Stone MD
• Children'S Service Center of Wyoming Valley Inc
• Chilson Clinic PC
• Chiropractic & Rehab Associates, P.C.
• Heidi Marie Clark, D.O.
• Rachel Clark
• Danielle Connell, LPC
• Kathryn Connor, LPC
• Daniel L Coster, D.O.

• Clinical Social Worker in Tunkhannock, PA
• Providers in Tunkhannock, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.