Annette M. Clark, LICSW
NPI 1366828477ActiveIndividual· Social Worker, Clinical· Bryan, TX
Social Worker, Clinical (LICSW) with Texas Aandm University System Health Science Center, practicing in Bryan, Texas. Enrolled in Medicare as practitioner - clinical social worker and practitioner - clinical social worker.
Overview
| NPI | 1366828477 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | No |
| NPI issued | Jul 31, 2015 |
| Last updated in NPPES | May 6, 2024 |
| Certified by provider | May 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 112234 | TX |
| Social Worker, Clinical | 1041C0700X | 11843 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN); Practitioner - Clinical Social Worker (TX) |
|---|
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Texas Aandm University System Health Science CenterBryan, TX · 37 clinicians
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