Patrick Jeremiah Clark in Waconia - Clinical
Patrick Jeremiah Clark - NPI 1235313388
Patrick Jeremiah Clark is a Clinical in Waconia, Minnesota. Patrick Jeremiah Clark practices all healthcare services and medical treatments related to Clinical. The NPI Number for Patrick Jeremiah Clark is 1235313388. The last update date is 2007-12-26.
Patrick Jeremiah Clark's current location address is 540 E First St, Waconia, Minnesota. You can contact this provider via phone number 9524424437 and fax number 9524422084. The mailing address for Patrick Jeremiah Clark is 540 E First St, Waconia, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Patrick Jeremiah Clark |
|---|---|
| Address | 540 E First St, Waconia, Minnesota |
| Phone Number | 9524424437 |
| Fax Number | 9524422084 |
| Sole Proprietor | N |
| Credentials | MSW |
NPI Number Detail
| NPI Number | 1235313388 |
|---|---|
| Provider Enumeration Date | 2007-12-26 |
| Last Updated Date | 2007-12-26 |
Provider Mailing Address Detail
| Address | 540 E First St |
|---|---|
| City | Waconia |
| State | Minnesota (MN) |
| Post Code | 553871601 |
| Phone Number | 9524424437 |
| Fax Number | 9524422084 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 16872LICSW |
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Definition: 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, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| HP84895 | MN | HEALTH PARTNERS |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Patrick Jeremiah Clark by the Centers for Medicare & Medicaid Services?
The Patrick Jeremiah Clark has been assigned the NPI (National Provider Identifier) 1235313388 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Patrick Jeremiah Clark is physically located?
The Patrick Jeremiah Clark is physically situated at the following address: 540 E First St, Waconia, MN, 553871601.
What is the Patrick Jeremiah Clark's area of specialization and corresponding taxonomy classification?
The Patrick Jeremiah Clark's specialty field is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their specialties.
On what date did the Patrick Jeremiah Clark receive the assignment of its 1235313388 from the Centers for Medicare & Medicaid Services?
The Patrick Jeremiah Clark was issued its 1235313388 by the Centers for Medicare & Medicaid Services on 2007-12-26.
As of what date were the details related to Patrick Jeremiah Clark most recently updated or revised?
The information pertaining to Patrick Jeremiah Clark, including its address, specialty, and other relevant details, was last updated or revised on 2007-12-26.