Tayler Simone Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9047-123 Issued in WI

Practice address

4465 N Oakland Ave Unit 310
Shorewood, WI 53211-1662

Phone

(414) 775-3278

NPI assigned

May 23, 2017

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)

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 and National Provider Directory roles.

• Nova Mental Health Services, LLC

  • Clinical Social Worker
  • Shorewood, WI
  • NPI 1891375432
  NPD
• Family Options Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brookfield, WI
  • NPI 1437322807

  Clinical

  NPD (past)
• Family Options Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brookfield, WI
  • NPI 1164571667

  Clinical

  NPD (past)
• Multicultural Trauma and Addiction Treatment Center of Wisconsin

  • Professional Counselor
  • Wauwatosa, WI
  • NPI 1376013516
  NPD (past)

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1982132817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3034 S WENTWORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532073017",
            "telephone_number": "608-213-9869",
            "fax_number": "414-310-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 N OAKLAND AVE UNIT 310",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111662",
            "telephone_number": "414-775-3278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4536 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "53140",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4536 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "53140",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 N Mayfair Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532262262",
            "country_code": "US",
            "telephone_number": "414-939-9390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2867 S Kinnickinnic Ave Apt 318",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532072269",
            "country_code": "US",
            "telephone_number": "608-213-9869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N19W24400 Riverwood Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531881182",
            "country_code": "US",
            "telephone_number": "414-774-3278",
            "fax_number": "414-310-1760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TAYLER",
        "middle_name": "SIMONE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9047-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Mind Solutions-Milwaukee S.C.
• Chiropractic Company - Shorewood
• CHP Shorewood Wi Tenant Corp
• Alexa Christensen
• Noel Anne Clark, MS CCC SLP
• Robert Edward Coleman Jr., ND, LMT
• Salonda Coleman
• Peter James Colosimo, D.D.S.
• Peter P Colosimo, DDS
• Alisa Renee Conroy, PHARMD

• Clinical Social Worker in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.