Julie R Clark, MA CCC SLP L

Key facts

NPI

1649577800

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

0201341 (NY)

Practice address

118 N Pearl St
Frewsburg, NY 14738-9514

Phone

(716) 708-2025

NPI assigned

Feb 23, 2011

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

Master of Arts

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 11, 2026.

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1649577800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 FAIRMOUNT AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012609",
            "telephone_number": "716-338-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N PEARL ST",
            "city": "FREWSBURG",
            "state": "NY",
            "postal_code": "147389514",
            "telephone_number": "716-708-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JULIE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MA CCC SLP L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "0201341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frewsburg, NY

• Cherie Ann Anderson, RN
• Saima Batool
• Amy Carmen, RN
• Kelli Marie Conklin
• Terra Lynne Devereaux, MS, CCC-SLP/L
• Frewsburg Central School District
• Frewsburg Fire District
• Frewsburg Rest Home, Inc.

All providers in Frewsburg, NY · Speech-Language Pathologist in New York