Kelli Marie Clark
NPI 1104196815ActiveIndividual· Social Worker, Clinical· Massena, NY
Social Worker, Clinical in Massena, New York, licensed in NY, with an NPI issued in January 2012. Enrolled in Medicare as order and referring only - clinical social worker.
Overview
| NPI | 1104196815 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jan 11, 2012 |
| Last updated in NPPES | Apr 24, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | R054044-1 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Clinical Social Worker (NY) |
|---|
Other clinical social workers in Massena
- 1215619887
- 1841508082
- 1003095795
- 1770650897
- 1780268706
- 1821596651
- 1891828679
- 1154450880
- 1780935759
- 1285882852
- 1356480610
- 1558680512
All 20 clinical social workers in Massena · All clinical social workers in New York