Patrick L Clark, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW-7071T Issued in AZ

Practice address

12286 N New Dawn Ave
Oro Valley, AZ 85755-1602

Phone

(708) 473-2043

NPI assigned

Nov 10, 2021

Last updated

Nov 10, 2021By the provider in NPPES

Sex

Male

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 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

Fordham University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pusch Ridge Behavioral Health LLCGroup PAC ID 7416310438, 9 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.

• Pusch Ridge Behavioral Health LLC

  dba Pusch Ridge Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1376140459
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1942966346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12286 N NEW DAWN AVE",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551602",
            "telephone_number": "708-473-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12286 N NEW DAWN AVE",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857551602",
            "telephone_number": "708-473-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PATRICK",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LMSW-7071T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Euodia Chua, PHD
• Chula Vista Professional Corporation (Chiropractic USA)
• Deborah Jane Clamp, LCSW
• Daniel Clark, RPH
• Judith Alice Clark, RPH
• Trezah Clark, CRNA
• Garrett Quinn Clary
• Gina Cliett, MD
• Benny Cocio II, D.C.
• Laura Coco

• Clinical Social Worker in Oro Valley, AZ
• Providers in Oro Valley, 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 Nov 10, 2021; 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.