Grant David Clarke, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS24617 Issued in CA

Practice address

140 E Commonwealth Ave Ste 101
Fullerton, CA 92832-1905

Phone

(714) 773-4111

Fax

(714) 773-4222

NPI assigned

Feb 4, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunny Hills Behavioral Health IncGroup PAC ID 0244299139, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Sunny Hills Behavioral Health, Inc.

  • Psychiatry Physician
  • Fullerton, CA
  • NPI 1467551200
  Medicare reassignment Care Compare group NPD
• Gaining Clarity Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Anaheim, CA
  • NPI 1437713898
  NPD Authorized official
• Countywide Resource Management

  • Mental Illness Community Based Residential Treatment Facility
  • Los Angeles, CA
  • NPI 1528220407
  NPD (past)

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1689812265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 DALY ST",
            "address_2": "2ND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900313309",
            "telephone_number": "323-226-4448",
            "fax_number": "323-223-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E COMMONWEALTH AVE STE 101",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321905",
            "telephone_number": "714-773-4111",
            "fax_number": "714-773-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "GRANT",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS24617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie-Anne Clark, PA-C
• Madison Mimi Clark
• Olivia Clark
• Tracey Clark, M.A., LMFT
• Clarke Lew Medical Corp
• Marisa Clarke
• Sharray Marie Clarke
• Clarvida
• Ellianna Marie Maligaya Claudio
• Jordan Clay

• Clinical Social Worker in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.