BONNIE CLARK (NPI# 1770700130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770700130 |
| Entity Type | Individual |
| Full Name | BONNIE CLARK |
| Credential | LCSW-R |
| Practice Address |
280 Princeton Avenue Ext Corning NY 14830-1524 |
| Practice Telephone | 6079623148 |
| Practice Fax Number | 6079628842 |
| Mailing Telephone | 6079623148 |
| Mailing Fax Number | 6079628842 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2009-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CW012420 | PA | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
RO68813 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | EXCELLUS BLUE CROSS BLUE SHIELD | 160743189 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104173822 | Bonnie J Clark | Licensed Practical Nurse | 47 Caton Rd, Corning, NY 14830-3741 | 2012-08-13 |
| 1306134341 | Bonnie Kathleen Clark | Physical Therapist | 197 E Broadway St, Danville, IN 46122-1803 | 2011-07-12 |
| 1063563310 | Bonnie L Clark | Nurse Practitioner | 5 Silver Rdg, Veazie, ME 04401-7086 | 2007-01-15 |
| 1710074570 | Bonnie Lou Clark | Nurse Practitioner | 200 East Main Avenue, Suite 202, Bismarck, ND 58501 | 2006-10-05 |
| 1063989960 | Bonnie Clark | Counselor | 20370 Poe Sholes Dr, Bend, OR 97703-7938 | 2018-10-29 |
| 1831472133 | Bonnie Lou Clark | Nurse Practitioner | 1319 Duncan Ave, Jeffersonville, IN 47130-3759 | 2011-09-22 |
| 1306124540 | Bonnie Clark | Pharmacist | 3200 Vine St, Cincinnati, OH 45220-2213 | 2011-07-21 |
| 1376672428 | Bonnie Clark | Licensed Psychiatric Technician | 1680 Walden Ave, Cheektowaga, NY 14225-4914 | 2007-03-05 |
| 1154355204 | Bonnie B Clark | Nurse Practitioner | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2006-07-11 |
| 1508899170 | Bonnie Clark | Physician Assistant | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2006-07-08 |
| Street Address |
280 PRINCETON AVENUE EXT |
| City | CORNING |
| State | NY |
| Zip Code | 14830-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689712820 | Candice A Cleveland | Counselor | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2007-02-01 |
| 1669017281 | Lyndsay Victoria Zastawny | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2019-11-07 |
| 1215571351 | Angela Marie Button | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2019-11-01 |
| 1598230237 | Alisha Renee Ost | Counselor | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2018-10-09 |
| 1902308679 | Diione Fox-murch | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2018-03-08 |
| 1518404516 | Donna Jo Wood | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2017-01-27 |
| 1518411941 | Kelsey A. Skerpan | Counselor | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2016-08-15 |
| 1437498045 | Karin Lewis | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2013-02-04 |
| 1205197605 | Nichole Renee Eaton | Counselor | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2012-06-01 |
| 1962785766 | Renae Katherine Carapella-johnson | Counselor | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2011-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295358836 | Shehla Javed | Registered Nurse | 3 Corning Dr, Corning, NY 14830 | 2020-05-18 |
| 1285993246 | Karen Adams | Physical Therapy Assistant | 205 E. First, Corning, NY 14830 | 2012-05-11 |
| 1275802464 | Anne Bethany Stefanini | Registered Nurse | 36 Mcmahon Avenue, Corning, NY 14830 | 2011-12-19 |
| 1548538119 | Elizabeth Ruth Costello | Registered Nurse | 11 West Third Street, Corning Free Academy, Corning, NY 14830 | 2011-12-09 |
| 1760769418 | Elizabeth Regina Feulner | Registered Nurse | 143 Princton Ave, Northside Blodgett Middle School, Corning, NY 14830 | 2011-11-09 |
| 1073823423 | Joyce Berliner | Occupational Therapist | 33 Denison Parkway West, Corning, NY 14830 | 2010-10-19 |
| 1285880625 | Angie L. Degraff-dacey | Licensed Practical Nurse | 160 Florentia Ln E, Corning, NY 14830 | 2008-08-18 |
| 1003098393 | Marcia Louise Ritter | Pharmacist | 601 West Pulteney Street, Corning, NY 14830 | 2007-11-29 |
| 1023203247 | Suzan S Fenstermacher | Physician Assistant | 88 Tioga Ave., Suite 102, Corning, NY 14830 | 2007-09-11 |
| 1205047313 | Katherine Ann Colyer | Physical Therapist | 11849 East Corning Rd, Suite 108, Corning, NY 14830 | 2007-05-24 |
| Find all providers in zip 14830 | ||||
| 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 |
|---|---|---|---|---|
| 1063955755 | Martha Thompson | Social Worker | 10486 South Rd, Corning, NY 14830-3200 | 2016-11-29 |
| 1417133935 | Janice Kirsten Vitale | Social Worker | 14 E Market St Ste 201, Corning, NY 14830-2681 | 2008-01-15 |
| 1942413810 | Joann Morse-clough | Social Worker | 23 W Market St Ste 208, Corning, NY 14830 | 2007-05-08 |
| 1083702328 | Denise Rae Smith | Social Worker | 3531 Columbia Ave, Corning, CA 96021-9650 | 2006-10-11 |
| 1639104920 | Stacy R Arnell | Social Worker | 602 David Street, Corning, AR 72422 | 2006-07-12 |
| 1407847353 | Connie Marie Massie | Social Worker | 519 Solano St C, Corning, CA 96021-3455 | 2005-10-31 |
| 1407418577 | Nicole K Terrio | Social Worker | 77 E 1st St, Corning, NY 14830-2715 | 2019-06-28 |
| 1619471422 | Jennifer Close | Social Worker | 77 E 1st St, Corning, NY 14830-2715 | 2018-03-19 |
| 1902308679 | Diione Fox-murch | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2018-03-08 |
| 1053833061 | Katie Jean Wells | Social Worker | 602 David St, Corning, AR 72422-7268 | 2017-07-11 |
| Find all providers in CORNING | ||||
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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.