Shelley Clark, LICSW
NPI 1063235992 · Clinical Social Worker · Vancouver, WA
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shelley Clark, LICSW is a Clinical Social Worker provider in Vancouver, WA (NPI 1063235992).
Provider details
- NPI number
- 1063235992
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- LW61516470 (WA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 1615 Delaware StLongview, WA 98632-2367Phone: (360) 414-2091
- 1718 E Kessler BlvdLongview, WA 98632-1842Phone: (360) 747-5800Fax: (360) 575-3846
Registry dates
- Enumerated
- 2024-11-07
- Last updated
- 2024-12-10
- Certified
- 2024-12-10
Frequently asked questions
- What is Shelley Clark's NPI number?
- Shelley Clark's National Provider Identifier (NPI) is 1063235992, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shelley Clark's specialty?
- Shelley Clark is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Shelley Clark located?
- Shelley Clark's practice location on file with NPPES is 2513 Nw 117th St, Vancouver, WA 98685-3667.
- What is Shelley Clark's phone number?
- The practice phone number listed in the NPPES registry for Shelley Clark is (360) 991-6272.
- Does Shelley Clark accept Medicare?
- Shelley Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shelley Clark's NPI active?
- Yes — Shelley Clark's NPI (1063235992) is active in the NPPES registry as of the last update on 2024-12-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.