Shelley Lynn Clark, LICSW
NPI 1063235992ActiveIndividual· Social Worker, Clinical· Vancouver, WA
Social Worker, Clinical (LICSW) with Peacehealth, practicing in Vancouver, Washington. Enrolled in Medicare as practitioner - clinical social worker. Lists Ascension Sacred Heart Bay as a hospital affiliation.
Overview
| NPI | 1063235992 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | Yes |
| NPI issued | Nov 7, 2024 |
| Last updated in NPPES | Dec 10, 2024 |
| Certified by provider | Dec 10, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | LW61516470 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WA) |
|---|
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- PeacehealthLongview, WA · 195 clinicians
Hospital affiliation
- Ascension Sacred Heart BayPanama City, FL
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