Mary Clark, LICSW
NPI 1639053929 · Clinical Social Worker · Ponte Vedra Beach, FL
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mary Clark, LICSW is a Clinical Social Worker provider in Ponte Vedra Beach, FL (NPI 1639053929).
Provider details
- NPI number
- 1639053929
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- 6365C (AL)
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
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Registry dates
- Enumerated
- 2025-08-01
- Last updated
- 2025-08-01
- Certified
- 2025-08-01
Frequently asked questions
- What is Mary Clark's NPI number?
- Mary Clark's National Provider Identifier (NPI) is 1639053929, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mary Clark's specialty?
- Mary Clark is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Mary Clark located?
- Mary Clark's practice location on file with NPPES is 310 S Ocean Grande Dr Unit 101, Ponte Vedra Beach, FL 32082-6539.
- What is Mary Clark's phone number?
- The practice phone number listed in the NPPES registry for Mary Clark is (251) 422-2148.
- Does Mary Clark accept Medicare?
- Mary Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mary Clark's NPI active?
- Yes — Mary Clark's NPI (1639053929) is active in the NPPES registry as of the last update on 2025-08-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.