Adam Clark, LCSW
NPI 1699276287ActiveIndividual· Social Worker, Clinical· Coquille, OR
Social Worker, Clinical (LCSW) with Waterfall Clinic Incorporated, practicing in Coquille, Oregon. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1699276287 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | Feb 28, 2018 |
| Last updated in NPPES | Sep 3, 2020 |
| Certified by provider | Sep 3, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | L8122 | OR |
| Social Worker, Clinical | 1041C0700X | CSW.09924908 | CO |
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 (OR) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Waterfall Clinic IncorporatedNorth Bend, OR · 14 clinicians
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