Active NPI
Julie Marie Doran Clark, LISW
- Clinical Social Worker
- Iowa City, IA
National Provider Identifier
1780868190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 05915
- Practice address
- 2533 Scott Blvd SE
Iowa City, IA 52240-8195 - Phone
- (319) 338-9212
- Fax
- (319) 354-8956
- NPI assigned
- Dec 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 05915 | IA | Primary |
Addresses
Primary practice location
2533 Scott Blvd SE
Iowa City, IA 52240-8195
Mailing address
2533 Scott Blvd SE
Iowa City, IA 52240-8195
Phone (319) 338-9212
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 |
|---|---|---|---|
| 05915 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1780868190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2533 SCOTT BLVD SE",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522408195",
"telephone_number": "319-338-9212",
"fax_number": "319-354-8956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2533 SCOTT BLVD SE",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522408195",
"telephone_number": "319-338-9212",
"fax_number": "319-354-8956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JULIE",
"middle_name": "MARIE DORAN",
"name_prefix": "Mrs.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-20",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "05915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.