Edward A Clarke, LMSW
Individual provider Active NPI Social Worker · Mason, MI
NPI 1750494662 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1750494662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6801006088 (MI)
- Practice address
- 3700 Josephine LN
Mason, MI 48854-9540 - Phone
- (517) 676-9577
- Fax
- (517) 676-3057
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801006088 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801006088 | MI | Yes |
Addresses
Primary practice location
3700 Josephine LN
Mason, MI 48854-9540
Mailing address
3700 Josephine LN
Mason, MI 48854-9540
Phone (517) 676-9577
Other providers in Mason, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.