National Provider Identifier
Bonnie Clark, LCSW-R
Bonnie Clark, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Corning, NY and a listed phone number of (607) 962-3148.
Profile Overview
- NPI
- 1770700130
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- April 19, 2007
- Last Updated
- December 31, 2009
Practice Location
- 280 Princeton Avenue Ext
- Corning, NY 14830-1524
Phone: (607) 962-3148
Specialties
- Clinical Social Worker (1041C0700X)
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1770700130
- Entity Type
- Individual
- Last Name
- Clark
- First Name
- Bonnie
- Credential
- LCSW-R
- Mailing Street Address
- 280 Princeton Avenue Ext
- Mailing City
- Corning
- Mailing State
- NY
- Mailing ZIP Code
- 14830-1524
- Mailing Country
- US
- Mailing Phone
- (607) 962-3148
- Mailing Fax
- (607) 962-8842
- Practice Street Address
- 280 Princeton Avenue Ext
- Practice City
- Corning
- Practice State
- NY
- Practice ZIP Code
- 14830-1524
- Practice Country
- US
- Practice Phone
- (607) 962-3148
- Practice Fax
- (607) 962-8842
- Enumeration Date
- April 19, 2007
- Last Updated
- December 31, 2009
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Clinical Social Worker (1041C0700X)
- Other Identifiers
- 160743189 (NY, Excellus Blue Cross Blue Shield)