Kim Clark is a Clinical in South Royalton, Vermont. Kim Clark practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kim Clark is 1508074311. The last update date is 2007-07-09.
Kim Clark's current location address is 226 Leonard Rd, South Royalton, Vermont. You can contact this provider via phone number 8027638773. The mailing address for Kim Clark is 226 Leonard Rd, South Royalton, Vermont. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim Clark |
|---|---|
| Address | 226 Leonard Rd, South Royalton, Vermont |
| Phone Number | 8027638773 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | L.I.C.S.W. |
NPI Number Detail
| NPI Number | 1508074311 |
|---|---|
| Provider Enumeration Date | 2007-05-18 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 226 Leonard Rd |
|---|---|
| City | South Royalton |
| State | Vermont (VT) |
| Post Code | 50689565 |
| Phone Number | 8027638773 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 101057 |
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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 |
|---|---|---|---|
| OVN2222 | VT | -- |
Post Comment/ Review Below
What is the Kim Clark's unique identification number?
The Kim Clark has been assigned the NPI (National Provider Identifier) Number 1508074311 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Kim Clark's physical address?
The Kim Clark is physically located at 226 Leonard Rd, in the city of South Royalton, VT, with the postal code 50689565.
What is Kim Clark's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Kim Clark is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
On what date did the Kim Clark receive the assignment of its 1508074311 from the Centers for Medicare & Medicaid Services?
The Kim Clark was issued its 1508074311 by the Centers for Medicare & Medicaid Services on 2007-05-18.
As of what date were the details related to Kim Clark most recently updated or revised?
The information pertaining to Kim Clark, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-09.
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