Patrick Michael Clark, LMSW
NPI 1104513506ActiveIndividual· Social Worker, Clinical· Waterloo, NY
Social Worker, Clinical (LMSW) in Waterloo, New York, licensed in NY and MN, with an NPI issued in April 2023.
Overview
| NPI | 1104513506 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LMSW |
| Sole proprietor | Yes |
| NPI issued | Apr 18, 2023 |
| Last updated in NPPES | Aug 25, 2025 |
| Certified by provider | Aug 25, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 128055-01 | NY |
| Social Worker, Clinical | 1041C0700X | 29834 | MN |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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