DR. PAUL G CLARK (NPI# 1174893945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174893945 |
| Entity Type | Individual |
| Full Name | DR. PAUL G CLARK |
| Credential | LCSW |
| Practice Address |
4400 University Dr Fairfax VA 22030-4422 |
| Practice Telephone | 7039932737 |
| Mailing Telephone | 7039932737 |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
SW0002836 | FL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
0904-001362 | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235540931 | Paul A Clark | Physical Therapist | 410 Avenue G, Levelland, TX 79336-3719 | 2014-05-15 |
| 1154338945 | Paul K Clark | Chiropractor | 725 E Commercial Ave, Lowell, IN 46356-2303 | 2006-08-02 |
| 1396769154 | Paul Anthony Clark | Dentist | 759 E 200th St, Euclid, OH 44119-2504 | 2006-07-26 |
| 1124594742 | Paul Edward Clark | Social Worker | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2018-10-22 |
| 1619362597 | Paul Ray Clark | Student in an Organized Health Care Education/Training Program | 6431 Fannin St, Msb 4.331, Houston, TX 77030-1501 | 2015-03-30 |
| 1174939102 | Paul Clark | Physical Therapist | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2014-07-10 |
| 1619388659 | Paul Richard Clark | Student in an Organized Health Care Education/Training Program | 2500 N State St, Department of Neurosurgery, Jackson, MS 39216-4500 | 2014-05-13 |
| 1083051684 | Paul E Clark | Social Worker | 47 Town St, Norwich, CT 06360-2315 | 2013-05-23 |
| 1306289699 | Paul Allen Clark | Occupational Therapist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2013-04-17 |
| 1841569878 | Paul Thomas Clark | Counselor | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2011-12-20 |
| Street Address |
4400 UNIVERSITY DR |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-4422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245210079 | Mary E. Davis | Nurse Practitioner | 4400 University Dr, Ms 2d3, Fairfax, VA 22030-4422 | 2006-01-18 |
| 1326685207 | Yusufu Kamara | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-10 |
| 1861039752 | Kathy Nguyen | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-10 |
| 1093352007 | Phung Kim Pham | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-09 |
| 1083251169 | Hailey Arnold | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4444 | 2019-12-08 |
| 1376180471 | Latoya Marie Lashley | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-08 |
| 1609413715 | Claudia Talton | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-08 |
| 1063059152 | Ali Ahmad | Specialist/Technologist | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-08 |
| 1386281467 | Archana Bai Reddy | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-07 |
| 1861039331 | Janet Rae Stein | Student in an Organized Health Care Education/Training Program | 4400 University Dr, Fairfax, VA 22030-4422 | 2019-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234021 | Sabrina Kafin Weiskind | Social Worker | 13221 Point Pleasant Dr, Fairfax, VA 22033-3508 | 2020-10-30 |
| 1154920163 | Vera D Daniel | Social Worker | 4110 Chain Bridge Rd Ste 316, Fairfax, VA 22030-4020 | 2020-10-21 |
| 1154931632 | Brooke Varma | Social Worker | 2971 Lismore Ln, Fairfax, VA 22031-2138 | 2020-08-09 |
| 1922629179 | Emily Tilman | Social Worker | 3524 Country Hill Dr, Fairfax, VA 22030-1818 | 2020-04-29 |
| 1790318236 | Joyce L Montgomery | Social Worker | 10615 Judicial Dr Ste 103, Fairfax, VA 22030-7501 | 2020-02-12 |
| 1356972368 | Minoo Pakdaman | Social Worker | 4290 Birney Ln, Fairfax, VA 22033-4333 | 2020-01-29 |
| 1790323467 | Dorine Ndayizigiye | Social Worker | 10615 Judicial Dr Ste 301, Fairfax, VA 22030-7501 | 2019-12-12 |
| 1245897776 | Susan Morris Robertory | Social Worker | 9117 Kristin Ln, Fairfax, VA 22032-1424 | 2019-05-21 |
| 1083183032 | Brooke Diane Postlewaite | Social Worker | 4110 Chain Bridge Rd Ste 214, Fairfax, VA 22030-4020 | 2018-11-20 |
| 1871061499 | Michelle Brown | Social Worker | 8221 Willow Oaks Corporate Dr # L-306g, Fairfax, VA 22031-4512 | 2018-11-13 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.