Johanna Daniela Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093547 Issued in NY

Practice address

1107 Stokes Ave
Collingswood, NJ 08108-3307

Phone

(856) 617-1896

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Delaware County Professional Services, Inc

  • Psychiatry Physician
  • Media, PA
  • NPI 1952485864
  NPD (past)
• Marvin Behavioral Health Ma PC

  • Psychologist
  • Boston, MA
  • NPI 1740860428

  Clinical

  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1508962408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 STOKES AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083307",
            "telephone_number": "856-617-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 STOKES AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083307",
            "telephone_number": "856-617-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOHANNA",
        "middle_name": "DANIELA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093547",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ann Charlton, MA, LPC
• Abigail Charpentier
• Christine A Chew, OT
• Children'S Opportunity Center
• Ronald P. Ciccone, M.D.
• Rebecca Elizabeth Clark
• Joseph Samuel Cohen
• Alex A. Colalillo Jr., D.D.S.
• Karen Cole
• Monica Collazo

• Clinical Social Worker in Collingswood, NJ
• Providers in Collingswood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.