Kathleen M. Clark, L.C.S.W. , B.C.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S03218 Issued in TX

Practice address

3724 Jefferson St
Suite 206
Austin, TX 78731-6221

Phone

(512) 452-8948

Fax

(512) 452-0459

NPI assigned

Sep 23, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1740276906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST",
            "address_2": "SUITE 206",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316221",
            "telephone_number": "512-452-8948",
            "fax_number": "512-452-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST",
            "address_2": "SUITE 206",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316221",
            "telephone_number": "512-452-8948",
            "fax_number": "512-452-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "credential": "L.C.S.W. , B.C.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "S03218",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "3218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Clark, NP
• Jacob Zachary Clark, CRNA
• Jadyn Clark
• James Andrew Clark, PA-C
• Jordan Elisha Clark
• Keri Ann Clark, PT
• Margaret K Clark, M.D.
• Margi Anne Clark, RN
• Marguerite Lillie Clark, NP
• Mark Colin Clark, M.D.

• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.