Kenya S Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19233 Issued in AZ

Practice address

8705 E McDowell Rd
Scottsdale, AZ 85257-3909

Phone

(480) 882-4545

Fax

(480) 405-8929

NPI assigned

Mar 13, 2021

Last updated

Oct 10, 2023By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adelante Healthcare, IncGroup PAC ID 4688588643, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adelante Healthcare, Inc.

  dba Adelante Healthcare-Wickenburg

  • Federally Qualified Health Center (FQHC)
  • Wickenburg, AZ
  • NPI 1083772545
  Medicare reassignment Care Compare group NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  AZ

  Medicare reassignment NPD
• Adelante Healthcare, Inc

  dba Adelante Healthcare-Roosevelt

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1215734124
  NPD
• Adelante Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1528126133
  NPD
• Terros, Inc.

  dba Terros Health

  • Substance Abuse Rehabilitation Facility
  • Glendale, AZ
  • NPI 1487072351
  NPD (past)

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1881279669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122929",
            "telephone_number": "602-685-6000",
            "fax_number": "602-302-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 E MCDOWELL RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573909",
            "telephone_number": "480-882-4545",
            "fax_number": "480-405-8929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 N 51st Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853016057",
            "country_code": "US",
            "telephone_number": "602-685-6000",
            "fax_number": "602-930-0358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KENYA",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "19233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090238",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James P Clark, M.D.
• Jeffrey David Clark, DDS
• Jennifer Marie Clark, DDS
• Kendall Clark
• Kendra Marie Clark, PA-C
• Kristen M Clark, AUD
• Maria G Clark, LPC, LISAC
• Michael Allen Clark, RPH
• Ray Nelson Clark, PHARMD
• Robert Wallace Clark III, DDS

• Clinical Social Worker in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.