| Michael A Clark, LCSW | |
|
327 E Airport Dr, Carthage, MO 64836-3402 | |
| (417) 237-0604 | |
| (417) 237-0613 |
| Full Name | Michael A Clark |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 327 E Airport Dr, Carthage, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639958481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2022033941 (Missouri) | Primary |
| Entity Name | Sgoh Acquisition Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114924768 PECOS PAC ID: 5092616276 Enrollment ID: O20040205000647 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael A Clark, LCSW 327 E Airport Dr, Carthage, MO 64836-3402 Ph: (417) 237-0604 | Michael A Clark, LCSW 327 E Airport Dr, Carthage, MO 64836-3402 Ph: (417) 237-0604 |
Mrs. Melinda Sue Burchfield, MSW,LCSW, IBCLC Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1515 Hazel St, Carthage, MO 64836 Phone: 417-358-0188 Fax: 417-358-0189 | |
Brittany Johnson, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 221 W 4th St Ste 1, Carthage, MO 64836 Phone: 417-214-0881 | |
Raymond Houston Jr., MSW, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2411 Fairlawn Drive, Carthage, MO 64836 Phone: 417-388-9872 | |
Ruth Andrea West, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3071 S Grand Ave, Carthage, MO 64836 Phone: 417-358-4811 | |
Caroline R Charlton, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1632 Missouri Ave, Carthage, MO 64836 Phone: 417-358-7728 | |
Jannette Eldred, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1500 South Case Steet, Carthage, MO 64836 Phone: 417-358-7728 Fax: 417-358-1629 | |
Ms. Pamela D. Smith, M.S.W., L.C.S.W Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2405 Fairlawn Dr, Carthage, MO 64836 Phone: 417-359-8093 Fax: 417-359-8094 |