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NPI Code Detail

MEDICARE: SARAH E. CLARK LCSW

MEDICARE: SARAH E. CLARK LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34009055AIN

General Provider Information

NPI Number : 1629928908
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH E. CLARK LCSW
Provider Business Mailing Address
First Line : 5125 DECATUR BLVD STE B
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-7511
Country : US
Telephone Number : 317-851-5201
Fax Number :
Provider Business Practice Location Address
First Line : 5125 DECATUR BLVD STE B
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-7511
Country : US
Telephone Number : 317-851-5201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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