KELLI MARIE CLARK
NPI 1104196815
Social Worker - Clinical in Massena, NY

NPI Status: Active since January 11, 2012

Contact Information

23 MAPLE ST
MASSENA, NY
ZIP 13662
Phone: (315) 769-8441

Get Directions Reviews

  • Individual
  • Female
  • Social Worker
  • Clinical
  • PECOS Enrolled

About KELLI CLARK

Kelli Clark is a provider established in Massena, New York and her medical specialization is Social Worker with a focus in clinical . The healthcare provider is registered in the NPI registry with number 1104196815 assigned on January 2012. The practitioner's primary taxonomy code is 1041C0700X with license number R054044-1 (NY). The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI
1104196815
Provider Name
KELLI MARIE CLARK
Gender
Female
Entity Type
Individual
Location Address
23 MAPLE ST MASSENA, NY 13662
Location Phone
(315) 769-8441
Mailing Address
23 MAPLE ST MASSENA, NY 13662
Is Sole Proprietor?
Yes
Enumeration Date
01-11-2012
Last Update Date
04-24-2018
Code Navigator

A clinical social worker like Kelli Clark is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Social Worker Clinical

Taxonomy Code
1041C0700X
Type
Behavioral Health & Social Service Providers
License No.
R054044-1
License State
NY
Taxonomy Description
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

PECOS Enrollment and Medicare Participation Status

Kelli Clark is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for KELLI MARIE CLARK

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1104196815
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2104291282
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 0 + 4 + 2 + 9 + 1 + 2 + 8 + 2 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1104196815 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1033273016 STEPHANIE SARAH MONAGHAN-BAXTER MSW
Individual
Social Worker23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1154450880 CYNTHIA MARIE BABBITT LCSWR
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1285882852 ATHENA MARIE CURLEY L.M.S.W.
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1174848436MRS. NANCY MARIE ROBIDEAU RN
Individual
Registered Nurse23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1912223256MRS. ANGELIA MARIE BERNARD RN
Individual
Registered Nurse23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1891011128 KATHLEEN STRAKA
Individual
Counselor (Mental Health)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1750607990MS. EILEEN DELEHANTY MCKENNA LCSW-R
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1427374271MR. GEORGE LESHER VANBUSKIRK LCSW
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1558680512MS. MARGARET MARY DUNN LCSWR
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1841508082 REBECCA MONICA LOVE LCSW-R
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1326347758 PEGGY ELIZABETH GIBSON REGISTERED NURSE
Individual
Registered Nurse (Psychiatric/Mental Health)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1831464627 LUCY LEIGH OSHIER
Individual
Registered Nurse (Psychiatric/Mental Health)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1508117110MS. DEBORAH ANN WHALEN RN
Individual
Registered Nurse (Psychiatric/Mental Health, Adult)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1720471758 ASHLEY TODD
Individual
Registered Nurse (Psychiatric/Mental Health, Adult)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1518338789 JENNIFER GREENE
Individual
Social Worker (Clinical)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1285005439 LISA LANGTRY RN
Individual
Registered Nurse (Psychiatric/Mental Health, Adult)23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1699147066MR. MICHAEL LAAMAN LMSW
Individual
Social Worker23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1962874255MRS. CHARITY ANN SHOEN
Individual
Counselor23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1700258159ST. LAWRENCE PSYCHIATRIC CENTER
Organization
Psychiatric Hospital23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441
1770086910 KARA DUTCH
Individual
Rehabilitation Counselor23 MAPLE ST
MASSENA, NY 13662
(315) 769-8441

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104196815, enumerated in the NPI registry as an "individual" on January 11, 2012

The provider is located at 23 Maple St Massena, Ny 13662 and the phone number is (315) 769-8441

The provider's speciality is Social Worker with taxonomy code 1041C0700X with a focus in Clinical

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

This NPI record was last updated on January 11, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.