Provider Demographics
NPI:1922126309
Name:CLARKE, MARIAN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:ELIZABETH
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 NOBLE ST
Mailing Address - Street 2:APT 132
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563
Mailing Address - Country:US
Mailing Address - Phone:516-568-2040
Mailing Address - Fax:
Practice Address - Street 1:2201 HEMPSTEAD TURNPIKE
Practice Address - Street 2:NASSAU UNIVERSITY MEDICAL CENTER
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554
Practice Address - Country:US
Practice Address - Phone:516-572-6847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR01908711041C0700X
FLSW16371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical