Individual provider Active NPI

Jamison Grey Clark, LLMSW

  • Social Worker
  • Trenton, MI
National Provider Identifier
1487587614
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851121677 Issued in MI
Practice address
2871 West Rd
Trenton, MI 48183-2476
Phone
(734) 346-6430
NPI assigned
Jun 6, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 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 6851121677 MI Primary

Addresses

Primary practice location

2871 West Rd
Trenton, MI 48183-2476

Mailing address

715 S Forest Ave Apt 301
Ann Arbor, MI 48104-3151
Phone (678) 764-4253

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
6851121677MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1780704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1487587614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S FOREST AVE APT 301",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481043151",
            "telephone_number": "678-764-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 WEST RD",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832476",
            "telephone_number": "734-346-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMISON",
        "middle_name": "GREY",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-06",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851121677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.