Mary Elizabeth Beckley Clark, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801078536 Issued in MI

Practice address

57418 CR 681
Suite C
Hartford, MI 49057

Phone

(269) 621-6251

Fax

(269) 621-6044

NPI assigned

Sep 11, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Mary Elizabeth Beckley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1578758652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "address_2": "801 HAZEN STREET SUITE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490790249",
            "telephone_number": "269-657-5574",
            "fax_number": "269-657-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57418 CR 681",
            "address_2": "SUITE C",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "49057",
            "telephone_number": "269-621-6251",
            "fax_number": "269-621-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKLEY CLARK",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801078536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BECKLEY",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "MASTERS SOCIALWORKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ahad E Lotfi DC PLLC
• Marcella Elizabeth Bell Pitchford, LMSW
• Harmony Lynn Bennett
• Francene Marie Berglund, MASTERS LTD PSYCHOLO
• Julie Boersen
• Donnie D Bouchard, DO

• Social Worker in Hartford, MI
• Providers in Hartford, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.