Individual provider Active NPI

Mark E Claycomb, LCSW

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1790791796
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LCS135532 Issued in CA
Practice address
55 New Montgomery St
#420
San Francisco, CA 94105
Phone
(415) 522-7400
Fax
(445) 543-1932
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LCS135532 CA Primary
Social Worker 104100000X LCS13553 CA

Addresses

Primary practice location

55 New Montgomery St
#420
San Francisco, CA 94105

Mailing address

55 New Montgomery St
#420
San Francisco, CA 94105
Phone (415) 522-7400

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS135532CAMDPsychologist
LCS13553CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1790791796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NEW MONTGOMERY ST",
            "address_2": "#420",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94105",
            "telephone_number": "415-522-7400",
            "fax_number": "445-543-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NEW MONTGOMERY ST",
            "address_2": "#420",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94105",
            "telephone_number": "415-522-7400",
            "fax_number": "445-543-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYCOMB",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "LCS135532",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCS13553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.