Jeffery Duane Clark, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61435143 Issued in WA

Practice address

202 E Spokane Falls Blvd Ste 302
Spokane, WA 99202-1612

Phone

(509) 720-7073

NPI assigned

Feb 22, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  WA

  Medicare reassignment NPD
• Sondermind, P.a.

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1710647581

  Mental Health, WA

  Medicare reassignment NPD
• Horizon Enigma Counseling, PLLC

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1891660692
  NPD Authorized official
• Yfa Connections

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1619058997

  Addiction (Substance Use Disorder)

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769817600000",
    "number": "1225539570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E SPOKANE FALLS BLVD STE 302",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021612",
            "telephone_number": "509-720-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E SPOKANE FALLS BLVD STE 302",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021612",
            "telephone_number": "509-720-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEFFERY",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2026-01-31",
        "certification_date": "2026-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61435143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G9123877",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Clark
• Daniel Clark
• Dave Loren Clark, PT
• Elizabeth Sue Clark, MS, CCC-SLP
• James Lance Clark, PHARM. D.
• Jeffrey Clark, PHARM.D.
• Jennifer Clark, LICSW
• John Robert Clark, MD
• Karen Clark, R.PH
• Karly Michelle Clark

• Clinical Social Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.