Active NPI
Marilyn Foster Clark, LCPC
- Pastoral Counselor
- Baltimore, MD
National Provider Identifier
1740350081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- LC0487
- Practice address
- 5405 Purlington Way
Baltimore, MD 21212-3406 - Phone
- (410) 435-8683
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | LC0487 | MD | Primary |
Addresses
Primary practice location
5405 Purlington Way
Baltimore, MD 21212-3406
Mailing address
5405 Purlington Way
Baltimore, MD 21212-3406
Phone (410) 435-0868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC0487 | MD | MD | Pastoral Counselor |
Interoperability endpoints
- mclark59409@direct.hopkinsmedicine.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740350081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5405 PURLINGTON WAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212123406",
"telephone_number": "410-435-0868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 PURLINGTON WAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212123406",
"telephone_number": "410-435-8683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARILYN",
"middle_name": "FOSTER",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "MD",
"license": "LC0487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.