Judy Clarke
Individual provider Active NPI Clinical Social Worker · Avenel, NJ
NPI 1972199024 · NPPES record last updated Dec 14, 2020
Key facts
- NPI
- 1972199024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 090542 (NY)
- Practice address
- 104 Peach St
Avenel, NJ 07001-1002 - Phone
- (516) 647-8758
- NPI assigned
- Dec 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090542 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 090542 | NY | Yes |
Addresses
Primary practice location
104 Peach St
Avenel, NJ 07001-1002
Mailing address
104 Peach St
Avenel, NJ 07001-1002
Other providers in Avenel, NJ
- Joseph E Cerbone
- Roja Chirra
- Roma Chokshi
- David Chun
- Michael Robert Cipolla
- Colonia Pediatrics, LLC
- Creative Consulting Services, Inc.
- Clarinda Marie Cruz
- Gary Deguzman
- Delta Community Supports, Inc.
All providers in Avenel, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.