Susan Clark, LCSW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50038 Issued in TX

Practice address

1650 W Magnolia Ave
208
Ft Worth, TX 76104-4009

Phone

(817) 912-8006

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 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 and National Provider Directory roles.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1124809512
  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796
  NPD
• Scott and White Clinic

  • Radiation Oncology Physician
  • Waxahachie, TX
  • NPI 1821475153
  NPD

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1881754109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N BRITAIN RD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624559",
            "telephone_number": "214-395-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W MAGNOLIA AVE",
            "address_2": "208",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761044009",
            "telephone_number": "817-912-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "LCSW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881754109",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclark222104@direct.sw.org",
            "affiliation": "N",
            "address_1": "1307 8th Ave Ste 305",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Clark, LMT
• Lisamarie Helen Clark, OD
• Megan H Clark, S.L.P.
• Sandra Clark, LPC ASSOCIATE
• Sharon Ellen Clark, DO MPH
• Timiera Clark, OWNER
• Howard F Clarke Jr., PA
• Khalilah Q Clarke, MD
• Tyler A Clarke, LPC
• Sandra Lynne Clarkson, M.A., CCC-A, FAAA

• Clinical Social Worker in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.