David Burton Clark Jr., LSW
Social Worker in Toledo, OH. Individual provider (NPI-1).
NPI number1164071338
StatusActive
Last updated in NPPESSep 10, 2019
Details
- NPI
- 1164071338
- Entity type
- Individual (NPI-1)
- Name
- Mr. David Burton Clark Jr.
- Credential
- LSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 10, 2019
- Last updated
- Sep 10, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | – | OH | Yes |
| 104100000X | Social Worker | – | – |
Practice location
3170 W Central Ave Ste BToledo, OH 43606-2945
Phone 567-316-7353
Mailing address
3170 W Central Ave Ste BToledo, OH 43606-2945
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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