Vicki Lynn Clark, RN, LSW
Individual provider Active NPI Case Manager/Care Coordinator · Brookville, OH
NPI 1649415209 · NPPES record last updated Jan 5, 2018
Key facts
- NPI
- 1649415209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 13111 Westbrook Rd
Brookville, OH 45309-8732 - Phone
- (937) 833-4388
- NPI assigned
- Dec 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S 0028386 | OH | MD | Social Worker |
| RN 185313 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S 0028386 | OH | |
| Registered Nurse | 163W00000X | RN 185313 | OH | |
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
13111 Westbrook Rd
Brookville, OH 45309-8732
Mailing address
13111 Westbrook Rd
Brookville, OH 45309-8732
Phone (937) 833-4388
Other names
- Mrs. Vicki Lynn Clark
Other providers in Brookville, OH
- Brookville Local School District
- Erica Brown
- Danielle Carlson
- Nancy M Cera
- City of Brookville
- Thomas Clausen
- Angela Dawn Daniels
- Erin M Davenport
- Susan Frederica Davis-Brown
- Jessica Lynn Denlinger
All providers in Brookville, OH · Case Manager/Care Coordinator in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.