Provider Demographics
NPI:1376994186
Name:CLARKE, ZELAIKA (PHD, MSW, LSW, MED)
Entity Type:Individual
Prefix:DR
First Name:ZELAIKA
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:PHD, MSW, LSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 OWL DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:NY
Mailing Address - Zip Code:12547-5459
Mailing Address - Country:US
Mailing Address - Phone:914-648-5776
Mailing Address - Fax:
Practice Address - Street 1:18 OWL DR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:NY
Practice Address - Zip Code:12547-5459
Practice Address - Country:US
Practice Address - Phone:914-648-5776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1296831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical