Individual provider Active NPI

Courtney Clark

  • Clinical Social Worker
  • Saginaw, MI
National Provider Identifier
1265978712
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2100 Hemmeter Rd
Saginaw, MI 48603-3944
Phone
(989) 799-2100
NPI assigned
Jan 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2100 Hemmeter Rd
Saginaw, MI 48603-3944

Mailing address

2100 Hemmeter Rd
Saginaw, MI 48603-3944
Phone (989) 799-2100

Other practice location 1

527 Cobb St
Cadillac, MI 49601-2540
Phone (231) 775-3463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20210810002703 MI Practitioner - Clinical Social Worker 3779987946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saginaw Psychological Services IncGroup PAC ID 8426961467, 19 clinicians

Practice addresses (Care Compare)

2100 Hemmeter Rd
Saginaw, MI 48603-3944
Phone (989) 799-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saginaw Psychological Services, Inc. Social Worker CurrentSince Aug 5, 2021 Accepting new patients

Locations

2100 Hemmeter Rd
Saginaw, MI 48603
Phone (989) 799-2100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1265978712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HEMMETER RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033944",
            "telephone_number": "989-799-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HEMMETER RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033944",
            "telephone_number": "989-799-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "527 Cobb St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012540",
            "country_code": "US",
            "telephone_number": "231-775-3463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.