Altheresa Clark, is a
Social Worker - Clinical based in Miami, Florida. Altheresa Clark is licensed to practice in Florida (license number SW13295) and her current practice location is
111 Nw 183rd St Ste 404, Miami, Florida. She can be reached at her office (for appointments etc.) via phone at
(786) 524-4001.
NPI number for Altheresa Clark is 1710332333 and her current mailing address is 111 Nw 183rd St Ste 404, Miami, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1710332333.
Healthcare Provider's Profile
| Full Name | Altheresa Clark |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 111 Nw 183rd St Ste 404, Miami, Florida |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1710332333
- Provider Enumeration Date: 05/02/2016
- Last Update Date: 03/05/2024
Medical Identifiers
Medical identifiers for Altheresa Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710332333 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | SW13295 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW13295 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Altheresa Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Altheresa Clark,
111 Nw 183rd St Ste 404,
Miami, FL 33169-4619
Ph: (786) 524-4001 | Altheresa Clark,
111 Nw 183rd St Ste 404,
Miami, FL 33169-4619
Ph: (786) 524-4001 |
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