Debra Jean Clark, LCSW-R

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R058000-1 Issued in NY

Practice address

10 Market St
Suite 5
Oneonta, NY 13820-2655

Phone

(607) 432-1914

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Southside Chiropractic, LLC

  • Chiropractor
  • Oneonta, NY
  • NPI 1740305531
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1609896943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MARKET ST",
            "address_2": "SUITE 5",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202655",
            "telephone_number": "607-432-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MARKET ST",
            "address_2": "SUITE 5",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202655",
            "telephone_number": "607-432-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DEBRA",
        "middle_name": "JEAN",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R058000-1",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R058000-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "11662733",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylie Chesebro
• Danette Diane Christensen, OPTICIAN
• Todd Churchill, DO
• City of Oneonta
• City of the Hills Dental, P.C.
• Marybeth Clark
• Charmaine Clarke-Davis, FNP-BC
• Kassandra Claudy, NP
• Elizabeth Ruth Clegg-Richards
• Andrea Barbara Close, PA-C

• Mental Health Counselor in Oneonta, NY
• Providers in Oneonta, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.