Olinka Lashae Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3711 Rupp Dr Ste 200
Fort Wayne, IN 46815-4523

Phone

(260) 484-4600

Fax

(260) 848-4002

NPI assigned

Aug 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Ujima Therapeutic Services

  • Addiction (Substance Use Disorder) Counselor
  • Fort Wayne, IN
  • NPI 1275126955
  NPD Authorized official
• Specialized Alternatives for Families and Youth of Indiana, Inc.

  • Case Management Agency
  • Indianapolis, IN
  • NPI 1093875775
  NPD (past)

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1891341152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339058",
            "telephone_number": "419-695-8010",
            "fax_number": "606-328-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 RUPP DR STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154523",
            "telephone_number": "260-484-4600",
            "fax_number": "260-848-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "OLINKA",
        "middle_name": "LASHAE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "34010969A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kira Melissa Clark, MS, BCBA
• Lauren Elizabeth Clark
• Mackenzie Marie Clark, MS, LAT, ATC
• McKenzie Clark
• Melanie Clark
• Olivia Clark, RD
• Patricia L Clark, MD
• Quinlyn Clark, RBT
• Sarah Clark, RBT
• Sheleah Clark

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.