Keri L. Clark, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115570 Issued in MA

Practice address

36 N Bedford St
Suite 4
East Bridgewater, MA 02333-1186

Phone

(508) 345-8453

NPI assigned

Mar 25, 2010

Last updated

Mar 25, 2010By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1972827426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 OAK ST APT 63",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011369",
            "telephone_number": "508-345-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N BEDFORD ST",
            "address_2": "SUITE 4",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023331186",
            "telephone_number": "508-345-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KERI",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eileen Comeau, NP
• Mary L Comlin, LICSW
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• Nancy E Costello, MD

• Clinical Social Worker in East Bridgewater, MA
• Providers in East Bridgewater, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.