Mary Ann Sisto Clark in Staten Island - Clinical
Mary Ann Sisto Clark - NPI 1811017163
Mary Ann Sisto Clark is a Clinical in Staten Island, New York. Mary Ann Sisto Clark practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Ann Sisto Clark is 1811017163. The last update date is 2023-04-12.
Mary Ann Sisto Clark's current location address is 36 Beacon Ave, Staten Island, New York. You can contact this provider via phone number 8885165504. The mailing address for Mary Ann Sisto Clark is 36 Beacon Ave, Staten Island, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Ann Sisto Clark |
|---|---|
| Address | 36 Beacon Ave, Staten Island, New York |
| Phone Number | 8885165504 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1811017163 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2023-04-12 |
Provider Mailing Address Detail
| Address | 36 Beacon Ave |
|---|---|
| City | Staten Island |
| State | New York (NY) |
| Post Code | 103061351 |
| Phone Number | 8885165504 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 37371 |
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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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What is the unique 10-digit identifier code assigned to Mary Ann Sisto Clark by the Centers for Medicare & Medicaid Services?
The Mary Ann Sisto Clark has been issued the NPI (National Provider Identifier) 1811017163 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Mary Ann Sisto Clark located?
The Mary Ann Sisto Clark is located at 36 Beacon Ave, Staten Island, NY 103061351.
What is the Mary Ann Sisto Clark's area of specialization and corresponding taxonomy classification?
The Mary Ann Sisto 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 Centers for Medicare & Medicaid Services originally issue the 1811017163 to Mary Ann Sisto Clark?
The Centers for Medicare & Medicaid Services originally issued the 1811017163 to Mary Ann Sisto Clark on 2007-03-30.
When was the information pertaining to Mary Ann Sisto Clark most recently updated or revised?
The details related to Mary Ann Sisto Clark, including its address, specialty, and other relevant information, were last updated or revised on 2023-04-12.