Shanavier Clark
NPI 1477044071ActiveIndividual· Social Worker· Gulfport, MS
Social Worker with Coastal Family Health Center, Inc, practicing in Gulfport, Mississippi. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1477044071 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | May 21, 2018 |
| Last updated in NPPES | Nov 24, 2025 |
| Certified by provider | Nov 24, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | C11808 | MS |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — | — |
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 (MS) |
|---|
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Coastal Family Health Center, IncDiberville, MS · 47 clinicians
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