Active NPI
Charlotte Allegra Clark
- Social Worker
- South Boston, MA
National Provider Identifier
1578826491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 218335
- Practice address
- 8 Burke St Apt 151
South Boston, MA 02127-3328 - Phone
- (617) 534-9500
- NPI assigned
- Jun 18, 2012
- Last updated
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 218335 | MA | Primary |
Addresses
Primary practice location
8 Burke St Apt 151
South Boston, MA 02127-3328
Mailing address
1010 Massachusetts Ave
Boston, MA 02118-2600
Phone (617) 419-3408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218335 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1578826491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 MASSACHUSETTS AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182600",
"telephone_number": "617-419-3408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 BURKE ST APT 151",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "021273328",
"telephone_number": "617-534-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHARLOTTE",
"middle_name": "ALLEGRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "218335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Boston, MA
- Catholic Charitable Bureau of the Archdiocesse of Boston, Inc. Dba (Laboure Center Visiting Nurse Service)
- Pamela Cattel, MD
- Megan Catherine Chapman, NP
- City Point Behavioral Consulting PLLC
- Ciara Elizabeth Claffey, LICSW
- Diane Clarke Delehanty, LICSW
- Alexander Macleod Cohen, BA
- Hayley Colleran, RN
- Martha Collins, MD
- Christopher Francis Conboy, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.