Coral June Clark, MS, LSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

44SL06366100 Issued in NJ

Practice address

1500 Route 88 W
Brick, NJ 08724-2320

Phone

(732) 785-1900

NPI assigned

Jul 14, 2018

Last updated

Jul 14, 2018By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531526400000",
    "number": "1558847343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 MULLER AVE",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087213444",
            "telephone_number": "732-770-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 88 W",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242320",
            "telephone_number": "732-785-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 W Water St Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087537414",
            "country_code": "US",
            "telephone_number": "732-349-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CORAL",
        "middle_name": "JUNE",
        "name_prefix": "Ms.",
        "credential": "MS, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-14",
        "last_updated": "2018-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL06366100",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06366100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Ciampi, PHD
• Kimberly Rosella Cigna, RPH
• Annette Cioffi-Parker, OTR
• Samantha Cirlincione, LCSW
• Kristin Cizek, LPC
• Leanna Renee Clark, RDN
• James Aloysius Clarke, MD
• Paul G Clauss, PT
• Colleen Jayne Clayton, P.T.
• Tabitha Clifford, LSW

• Mental Health Counselor in Brick, NJ
• Providers in Brick, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2018; 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.