Individual provider Active NPI

Jada Clark

  • Social Worker
  • Washington, DC
National Provider Identifier
1245912112
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LG200004265 Issued in DC
Practice address
2041 Martin Luther King Jr Ave SE
Washington, DC 20020-7024
Phone
(240) 997-6579
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LG200004265 DC Primary

Addresses

Primary practice location

2041 Martin Luther King Jr Ave SE
Washington, DC 20020-7024

Mailing address

2041 Martin Luther King Jr Ave SE
Washington, DC 20020-7024
Phone (202) 547-8450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LG200004265DCMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1245912112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200207024",
            "telephone_number": "202-547-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200207024",
            "telephone_number": "240-997-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JADA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG200004265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.