Individual ProviderDiaon M ClarkeSocial WorkerBehavioral Health & Social Service ProvidersPractice Address6 Gramatan Ave Ste 607, Mount Vernon, NY 10550-3208(914) 837-8336(917) 604-6438PECOS EnrollmentThis provider is enrolled in PECOS as DIAON CLARKE.Based on the most recent information from CMS, provider Diaon M Clarke is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1164758009Provider TypeIndividualFull NameClarke, Diaon MTitleDr.CredentialLCSW-RGenderFemaleSole ProprietorYesEnumeration Date10/28/2009Last Updated2/18/2020Contact InformationPractice LocationPractice Address6 Gramatan Ave Ste 607, Mount Vernon, NY 10550-3208Phone(914) 837-8336Fax(914) 560-2135Mailing LocationMailing Address6 Gramatan Ave Ste 607, Mount Vernon, NY 10550-3208Phone(917) 604-6438FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense080420New YorkProvider IdentifiersIDDescriptionIssuerID1285628552DescriptionOtherIssuerAGENCYNew YorkID1295878577DescriptionMedicaidIssuerUnlistedNew York