MR. RANDOLPH LAIRD CLARK (NPI# 1245665363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245665363 |
| Entity Type | Individual |
| Full Name | MR. RANDOLPH LAIRD CLARK |
| Credential | MSW, LCSW |
| Practice Address |
6655 E Us Highway 36 Avon IN 46123-8923 |
| Mailing Address |
5101 E. Us Hwy 36 Suite 100 Avon IN 46123-6646 |
| Practice Telephone | 8887141927 |
| Practice Fax Number | 3172720807 |
| Mailing Telephone | 8887141927 |
| Mailing Fax Number | 3177459565 |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2017-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34007681A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568456036 | Randolph Clark | Internal Medicine | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2005-09-09 |
| 1649347097 | Randolph Lynn Clark | Dentist | 301 S Boulevard St, Suite 118, Edmond, OK 73034-3878 | 2006-11-29 |
| Street Address |
6655 E US HIGHWAY 36 |
| City | AVON |
| State | IN |
| Zip Code | 46123-8923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588527 | Larry Beeler | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2005-06-17 |
| 1396346623 | Adair Lynn Mcdonald | Counselor | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2020-11-03 |
| 1548874258 | Louise Magiera | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2020-09-01 |
| 1912518457 | Jessalyn Rose Harrington | Marriage & Family Therapist | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2020-08-10 |
| 1477192656 | Elizabeth Ann Craig | Counselor | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2020-01-05 |
| 1083263370 | Celia Freeman | Counselor | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2019-09-09 |
| 1497301246 | Yasmine Bond Ali | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2019-08-16 |
| 1285289512 | Chelsea Nicole Anderson | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2019-08-05 |
| 1154980761 | Erika Julia Forslund | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2019-06-07 |
| 1427616721 | Robyn Danielle Crumpacker | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2019-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018669 | Dienye Williams | Pharmacist | 108 North Sr 267, Avon, IN 46123 | 2019-11-25 |
| 1992353817 | Debra Blackwell | Technician | 8198 Montage Ave, Apt 104, Avon, IN 46123 | 2019-09-04 |
| 1932675766 | Blake Ponist | Occupational Therapist | 10940 E U S Highway 36, Rockville Rd, Avon, IN 46123 | 2018-10-19 |
| 1396238150 | Sarah Sweany | Dietitian, Registered | Iu Health West Cancer Center, 1111 North Ronald Reagen Pkwy Suite B1600, Avon, IN 46123 | 2018-06-07 |
| 1124516257 | Sheree Itza | Counselor | 6655 E Us Highway 36 Ste 100, Avon, IN 46123 | 2018-04-24 |
| 1255860607 | Jonathan Lambert | Dentist | 110 N Avon Ave B, Avon, IN 46123 | 2017-06-08 |
| 1023546629 | 10439 E Us Highway 36 Dental, LLC | Dentist | 10439 E Us Highway 36, Avon, IN 46123 | 2017-05-25 |
| 1902330756 | Melissa Wheatley | Occupational Therapy Assistant | 6294 Forest View Court, Avon, IN 46123 | 2017-04-19 |
| 1932555844 | Gal Marcan | Family Medicine | 1351 Ronald Reagan Pkwy Ste B, Avon, IN 46123 | 2016-05-10 |
| 1962871301 | Annette Joelene Oechsle | Health Educator | 1820 South County Road 525 East, Avon, IN 46123 | 2015-09-16 |
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| 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 |
|---|---|---|---|---|
| 1245877638 | Cara Noel Donahue | Social Worker | Farmington Valley Counseling Center, 111 Simsbury Rd, Avon, CT 06019 | 2019-12-04 |
| 1184194904 | Brittney Connery | Social Worker | 85 E High St, Avon, MA 02322-1218 | 2018-12-05 |
| 1497242481 | Dawn Cohen Lcsw, LLC | Social Worker | 152 Simsbury Rd Bldg 8, Avon, CT 06001-3777 | 2018-04-16 |
| 1194220996 | Theresa L. Hixson | Social Worker | 152 Simsbury Rd., Building 9, Avon, CT 06001 | 2018-03-26 |
| 1073054540 | Timothy Weitzel | Social Worker | 36419 Edenhall Terrace, Avon, OH 44011 | 2017-03-16 |
| 1548643810 | Marla Dakin | Social Worker | 111 Simsbury Rd Ste 104, Avon, CT 06001-3763 | 2015-07-06 |
| 1588074850 | Kimberly Wearne Levesque | Social Worker | 124 Simsbury Rd, Avon, CT 06001-3743 | 2014-05-07 |
| 1679907653 | Cynthia Mcquigg | Social Worker | 8103 Us Hwy 36, 158, Avon, IN 46123-7964 | 2013-08-27 |
| 1154673796 | Pamela H. Lefever | Social Worker | 40 Tower Ln, Avon, CT 06001-4222 | 2012-10-05 |
| 1972887081 | Salli Unhong Shon | Social Worker | 10 Mulberry Lane, Avon, CT 06001-0600 | 2011-10-07 |
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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.