Nicole Gianna Clark, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06581300 Issued in NJ

Practice address

7 Glenwood Ave Ste 101
East Orange, NJ 07017-1041

Phone

(862) 438-7983

NPI assigned

Nov 1, 2021

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

Electronic endpoints 1

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1497410989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GLENWOOD AVE STE 101",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171041",
            "telephone_number": "862-438-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 GLENWOOD AVE STE 101",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171041",
            "telephone_number": "862-438-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NICOLE",
        "middle_name": "GIANNA",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06581300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nclark@familyconnectionsnj.org",
            "affiliation": "Y",
            "endpointDescription": "Email Address",
            "affiliationName": "Family Connections",
            "address_1": "7 Glenwood Ave Ste 101",
            "city": "East Orange",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070171041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claremont Medical & Rehab Home Care Inc
• Claremont Medical and Rehabilitation Inc.
• Ruth Lynne Clark-Brown, M.D.
• Colleen Rose Clark
• Kevin Clark
• Herma B Clarke, PH.D,FACN,CNS,RD
• Robert A Clarke, MD
• Kerlange Claude-Alexandre
• Clear Path Transportation LLC
• Clear Pathways Community Supports

• Social Worker in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.