Holly Clark, LICSW
NPI 1649096702 · Clinical Social Worker · Minneapolis, MN
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Holly Clark, LICSW is a Clinical Social Worker provider in Minneapolis, MN (NPI 1649096702).
Provider details
- NPI number
- 1649096702
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- 23348 (MN)
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
2 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 (1)
- 333 Washington Ave N Ste 406Minneapolis, MN 55401-1370Phone: (971) 220-2127Fax: (844) 605-1865
Registry dates
- Enumerated
- 2024-11-22
- Last updated
- 2025-09-21
- Certified
- 2025-09-21
Frequently asked questions
- What is Holly Clark's NPI number?
- Holly Clark's National Provider Identifier (NPI) is 1649096702, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Holly Clark's specialty?
- Holly Clark is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Holly Clark located?
- Holly Clark's practice location on file with NPPES is 4826 Chicago Ave Ste 105, Minneapolis, MN 55417-1055.
- What is Holly Clark's phone number?
- The practice phone number listed in the NPPES registry for Holly Clark is (952) 201-5351.
- Does Holly Clark accept Medicare?
- Holly Clark is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Holly Clark's NPI active?
- Yes — Holly Clark's NPI (1649096702) is active in the NPPES registry as of the last update on 2025-09-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.