Grace I. Clark-Burch, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R076093-1 Issued in NY

Practice address

4711 Transit Rd
Suite 3 Forestream Village
Depew, NY 14043-4888

Phone

(716) 706-5921

Fax

(716) 706-5923

NPI assigned

Jun 7, 2006

Last updated

May 8, 2018By 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 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jenny T Bagen

  dba Transit Psychiatry

  • Adult Psychiatric/Mental Health Registered Nurse
  • Depew, NY
  • NPI 1417318379
  NPD (past)
• JT Bagen Enterprises Inc

  dba Transit Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Lancaster, NY
  • NPI 1992846497
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1922048180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943825",
            "telephone_number": "716-393-2905",
            "fax_number": "716-433-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 TRANSIT RD",
            "address_2": "SUITE 3 FORESTREAM VILLAGE",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140434888",
            "telephone_number": "716-706-5921",
            "fax_number": "716-706-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-BURCH",
        "first_name": "GRACE",
        "middle_name": "I.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R076093-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00030241501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000506354003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chester J. Gary, DDS and Mark D. Powalski, DDS, PC
• Jennifer Chouchani, P.A.
• Kathleen Ann Christie, M.S. P.T.
• Cichocki & Cichocki, LLP (Lancaster Depew Chiropractic)
• Jason D Cichocki, CICHOPRACTOR
• Denise J Clark-Voelker, OT
• Kevin G Cleary, MD
• Cassondra Marie Conrad-Cullinan
• Katelyn Coons
• Shayla Cooper

• Clinical Social Worker in Depew, NY
• Providers in Depew, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.