GEORGE CLARK (LICSW) – Social Worker, NPI 1801452040

GEORGE CLARK (LICSW) is a healthcare provider. based in Worcester, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 112041 (MA). The NPI Number for GEORGE CLARK (LICSW) is 1801452040

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
GEORGE CLARK (LICSW)
NPI
1801452040
Phone
(508) 792-5400
Address
10 MECHANIC ST STE 302
Enumeration Date
14 May 2019
Last Update Date
14 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5087976100
Graduation Year
2001 (25 years ago)
PAC ID
8527391630
Group Practice PAC ID
8224017082
Professional Enrollment ID
I20190605000078
Address ID
MA016032425WO1023XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

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Provider Addresses for GEORGE CLARK (LICSW)

  • 302, Mechanic Street, Leominster, Worcester County, Massachusetts, 01453, United States

    WORCESTER, MA 016082419

    Phone: (508) 792-5400

    Fax: (508) 831-0074

    Type: Mailing

  • 105, Merrick Street, Piedmont, Worcester, Worcester County, Massachusetts, 01609, United States

    WORCESTER, MA 016091937

    Phone: (508) 797-6100

    Fax: (508) 797-0693

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-06-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190605000078IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01608)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224017082View full group profile
NameSpecialtyState
Addiction Medicine, Family PracticeMA
Nurse PractitionerMA
Nurse PractitionerMA
Clinical Social WorkerMA
Nurse PractitionerMA
Nurse PractitionerMA
Addiction Medicine, Family PracticeMA
Psychiatry, Geriatric PsychiatryMA
Internal MedicineMA
-MA

Reviews

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Frequently asked questions

How do I look up GEORGE CLARK (LICSW) by NPI?
Use NPI 1801452040 when you need to reference GEORGE CLARK (LICSW) in forms, claims, or directories.
Is GEORGE CLARK (LICSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does GEORGE CLARK (LICSW) list a primary specialty?
If you are matching referrals, note Social Worker for GEORGE CLARK (LICSW). Clinical services aligned with this taxonomy classification.
Where is GEORGE CLARK (LICSW)'s primary listing?
We display Worcester, Massachusetts because that is what the record indicates for GEORGE CLARK (LICSW).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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