MS. AMY CLARK (LICSW) – Clinical Social Worker, NPI 1700955259

MS. AMY CLARK (LICSW) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 1340 (MN). The NPI Number for MS. AMY CLARK (LICSW) is 1700955259

Main info

Female
Sole Proprietor
32 Years Of Experience
Accepts Medicare Assignment
Name
MS. AMY CLARK (LICSW)
NPI
1700955259
Phone
(612) 816-2361
Address
3226 GARFIELD ST NE
Enumeration Date
7 November 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528841148
Graduation Year
1994 (32 years ago)
PAC ID
8123102191
Group Practice PAC ID
1759293954
Professional Enrollment ID
I20080228000718
Address ID
MN554202824BL8600XAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for MS. AMY CLARK (LICSW)

  • 3226, Northeast Garfield Street, Waite Park, Northeast, Minneapolis, Hennepin County, Minnesota, 55418, United States

    MINNEAPOLIS, MN 554182226

    Phone: (612) 816-2361

    Fax: (612) 788-9505

    Type: Mailing

  • 102, Marty Drive, Buffalo, Wright County, Minnesota, 55313, United States

    BUFFALO, MN 553139305

    Phone: (763) 682-5420

    Fax: (763) 682-5803

    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: 2008-02-28

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
I20080228000718IClinical Social WorkerMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes6011$0
View full utilization report →

Insurance plans in this area (ZIP 55418)

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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: 1759293954View full group profile

Reviews

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Frequently asked questions

What is the registry number for MS. AMY CLARK (LICSW)?
The registry entry for MS. AMY CLARK (LICSW) shows NPI 1700955259.
Should I treat MS. AMY CLARK (LICSW) as an active provider?
Patients and plans typically see MS. AMY CLARK (LICSW) as active in the national extract.
What does the directory say MS. AMY CLARK (LICSW) does?
Insurance directories may phrase it differently, but here MS. AMY CLARK (LICSW) maps to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What city is tied to MS. AMY CLARK (LICSW)?
The directory associates MS. AMY CLARK (LICSW) with Minneapolis, Minnesota. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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