KELLI MARIE CLARK NPI 1104196815
Social Worker - Clinical in Massena, NY
About KELLI MARIE CLARK
Kelli Clark is a provider established in Massena, New York and her medical specialization is Social Worker with a focus in clinical . The NPI number of this provider is 1104196815 and was 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 5 years ago.
| NPI | 1104196815 |
| Provider Name | KELLI MARIE CLARK |
| Location Address | 23 MAPLE ST MASSENA, NY 13662 |
| Location Phone | (315) 769-8441 |
| Mailing Address | 23 MAPLE ST MASSENA, NY 13662 |
| Gender | Female |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | Yes |
| Enumeration Date | 01-11-2012 |
| Last Update Date | 04-24-2018 |
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.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)..
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 1041C0700X |
| Classification | Social Worker |
| Type | Behavioral Health & Social Service Providers |
| Specialization | Clinical |
| 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. |
Business Address
23 MAPLE ST
MASSENA, NY
ZIP 13662
Phone: (315) 769-8441
Mailing Address
23 MAPLE ST
MASSENA, NY
ZIP 13662
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | No |
| Eligible order / refer Power Mobility Devices | No |
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. | |||||||||
| 1 | 1 | 0 | 4 | 1 | 9 | 6 | 8 | 1 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 2 | 9 | 12 | 8 | 2 | |
| 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 = 5 | 5 | ||||||||
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 Worker | 23 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 |
| 1174848436 | MRS. NANCY MARIE ROBIDEAU RN Individual | Registered Nurse | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1912223256 | MRS. ANGELIA MARIE BERNARD RN Individual | Registered Nurse | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1891011128 | KATHLEEN STRAKA Individual | Counselor (Mental Health) | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1750607990 | MS. EILEEN DELEHANTY MCKENNA LCSW-R Individual | Social Worker (Clinical) | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1427374271 | MR. GEORGE LESHER VANBUSKIRK LCSW Individual | Social Worker (Clinical) | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1558680512 | MS. 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 |
| 1508117110 | MS. 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 |
| 1699147066 | MR. MICHAEL LAAMAN LMSW Individual | Social Worker | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1962874255 | MRS. CHARITY ANN SHOEN Individual | Counselor | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1700258159 | ST. LAWRENCE PSYCHIATRIC CENTER Organization | Psychiatric Hospital | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
| 1770086910 | KARA DUTCH Individual | Rehabilitation Counselor | 23 MAPLE ST MASSENA, NY 13662 (315) 769-8441 |
Frequently Asked Questions
What is Kelli Clark NPI number?
The NPI number assigned to this healthcare provider is 1104196815, registered as an "individual" on January 11, 2012
Where is Kelli Clark located?
The provider is located at 23 Maple St Massena, Ny 13662 and the phone number is (315) 769-8441
Which is Kelli Clark specialty?
The provider's speciality is Social Worker with a focus in Clinical
Is Kelli Clark registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
How do I update my NPI information?
The NPI record of Kelli Clark 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].
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