Elaine Rutherford Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW0003279 Issued in FL

Practice address

501 Village Green Pkwy Ste 4
Bradenton, FL 34209-3401

Phone

(941) 795-7025

Fax

(941) 795-1480

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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 FL

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, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: elainerutherfordclark@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821142480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 VILLAGE GREEN PKWY STE 4",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093401",
            "telephone_number": "941-795-7025",
            "fax_number": "941-795-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 VILLAGE GREEN PKWY STE 4",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093401",
            "telephone_number": "941-795-7025",
            "fax_number": "941-795-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELAINE",
        "middle_name": "RUTHERFORD",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0003279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarity Psych Services
• Andrew Robert Clark, D.O.
• Angela C Clark, SLP
• Dalia Clark, MA
• Debra Diane Clark
• Jennifer Michele Clark, LCSW
• Mary Ann Clark, PH.D.
• Melissa Kipp Clark, AU.D.
• Michelle Elise Clark, N.D.
• Tatiana Clark, A.R.N.P.

• Clinical Social Worker in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Clinical Social Worker in Florida

• 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.
• 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.