Kenyetta Clark, LSW
Social Worker, Clinical in Maplewood, New Jersey
1295642643- Practice location
- 2115 Millburn Ave Ste 100, Maplewood, NJ 07040-3724
- Phone
- 908-308-4712
- Fax
- —
- Last updated
- August 24, 2026
Kenyetta Clark is a Social Worker, Clinical based in Maplewood, NJ. Kenyetta Clark practices in Maplewood, NJ and has the professional credentials of LSW. The NPI Number for Kenyetta Clark is 1295642643. The current practice location address for Kenyetta Clark is 2115 Millburn Ave Ste 100, Maplewood, NJ 07040-3724 and can be reached out via phone at 908-308-4712.
Provider Profile Details
- NPI Number
- 1295642643
- Provider Name
- Kenyetta Clark
- Credential
- LSW
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 2115 Millburn Ave Ste 100, Maplewood, NJ 07040-3724
- Phone Number
- 908-308-4712
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- August 24, 2026
- Last Update Date
- August 24, 2026
- Certification Date
- August 24, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2115 Millburn Ave Ste 100
Maplewood, NJ 07040-3724 - City
- Maplewood
- State
- New Jersey
- Zip
- 07040-3724
- Phone Number
- 908-308-4712
Provider Business Mailing Address Details
- Address
- 2115 Millburn Ave Ste 100
Maplewood, NJ 07040-3724 - City
- Maplewood
- State
- NJ
- Zip
- 07040-3724
- Phone Number
- 908-308-4712
License Information
- License State
- NJ
- Taxonomy
- Social Worker, Clinical · 1041C0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kenyetta Clark, LSW?
The NPI number of Kenyetta Clark, LSW is 1295642643. It was assigned on August 24, 2026 and is currently active in the NPPES registry.
What is the specialty of Kenyetta Clark, LSW?
Kenyetta Clark, LSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X).
Where does Kenyetta Clark, LSW practice?
The practice location is 2115 Millburn Ave Ste 100, Maplewood, NJ 07040-3724. The office can be reached at 908-308-4712 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1295642643 directly on the NPPES registry website.