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NPI Code Detail

MEDICARE: RACHEL CLARK LCSW-C

MEDICARE: RACHEL CLARK LCSW-C
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 WorkerLC50081969DC
21041C0700XClinical Social Worker27902MD

General Provider Information

NPI Number : 1962051128
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL CLARK LCSW-C
Provider Business Mailing Address
First Line : 10910 CLARKSVILLE PIKE
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-6106
Country : US
Telephone Number : 917-887-4224
Fax Number :
Provider Business Practice Location Address
First Line : 10910 CLARKSVILLE PIKE
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-6106
Country : US
Telephone Number : 667-240-4234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2019
Last Update Date : 04/08/2026

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Directions to “ RACHEL CLARK LCSW-C” Practice Location

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