| Amy M Clark Lcsw & Associates Llc | |
|
130 Bridge St Tunkhannock PA 18657-1354 | |
| (570) 575-2468 | |
| Not Available |
| Full Name | Amy M Clark Lcsw & Associates Llc |
|---|---|
| Speciality | Social Worker |
| Location | 130 Bridge St, Tunkhannock, Pennsylvania |
| Authorized Official Name and Position | Amy M Clark (PRESIDENT) |
| Authorized Official Contact | 5705752468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy M Clark Lcsw & Associates Llc 130 Bridge St Tunkhannock PA 18657-1354 Ph: (570) 575-2468 | Amy M Clark Lcsw & Associates Llc 130 Bridge St Tunkhannock PA 18657-1354 Ph: (570) 575-2468 |
| NPI Number | 1760853774 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 08/16/2016 |
| Medicare PECOS PAC ID | 7214215862 |
|---|---|
| Medicare Enrollment ID | O20161102000412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760853774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW018061 (Pennsylvania) | Primary |
| Provider Name | Amy M Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497056311 PECOS PAC ID: 6002032620 Enrollment ID: I20140716002407 |
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