Active NPI
Andrea Kathleen Clark, LMSW
- Social Worker
- Lawrence, KS
National Provider Identifier
1962836387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8885
- Practice address
- 200 Maine St Ste a
Lawrence, KS 66044-1396 - Phone
- (785) 843-9192
- Fax
- (785) 843-6744
- NPI assigned
- Aug 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 8885 | KS | Primary |
Addresses
Primary practice location
200 Maine St Ste a
Lawrence, KS 66044-1396
Mailing address
200 Maine St Ste a
Lawrence, KS 66044-1396
Phone (785) 843-9192
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841281805 | Other | KS | CENTER NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8885 | KS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420502400000",
"number": "1962836387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MAINE ST STE A",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660441396",
"telephone_number": "785-843-9192",
"fax_number": "785-843-6744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MAINE ST STE A",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660441396",
"telephone_number": "785-843-9192",
"fax_number": "785-843-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ANDREA",
"middle_name": "KATHLEEN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-22",
"last_updated": "2015-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "8885",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CENTER NPI",
"identifier": "1841281805",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.