Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelli Marie Clark

Individual provider Clinical Social Worker · NPI 1104196815

Kelli Marie Clark is a Clinical Social Worker in Massena, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012

Practice location Address checks out

23 Maple St
Massena, NY 13662-1017
Phone: (315) 769-8441
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R054044-1 (NY)

Record details

NPI number1104196815
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 11, 2012
Last updated in NPPESApril 24, 2018
Mailing address23 Maple St, Massena, NY 13662-1017

Other providers in Massena