ANNA LISA CLARK (LISW, LICDC) – Addiction (Substance Use Disorder) Counselor, NPI 1457376485

ANNA LISA CLARK (LISW, LICDC) is a healthcare provider. based in North ridgeville, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW, LICDC. They hold a License No. I-0007941 (OH). The NPI Number for ANNA LISA CLARK (LISW, LICDC) is 1457376485

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
ANNA LISA CLARK (LISW, LICDC)
NPI
1457376485
Phone
(440) 327-1800
Address
35888 CENTER RIDGE RD
Enumeration Date
12 July 2006
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
8666300966
Graduation Year
1995 (31 years ago)
PAC ID
4284690728
Group Practice PAC ID
9537572490
Professional Enrollment ID
I20140131000587
Address ID
OH432154206CO20XXXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:19State licenses:2Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

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Provider Addresses for ANNA LISA CLARK (LISW, LICDC)

  • 35888, Center Ridge Road, North Ridgeville, Lorain County, Ohio, 44039, United States

    SUITE 5

    NORTH RIDGEVILLE, OH 440393086

    Phone: (440) 327-1800

    Fax: (440) 327-1533

    Mailing address matches the actual address.

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: 2014-01-31

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
I20140131000587IClinical Social WorkerOHTBD

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 44039)

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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: 9537572490View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
Clinical PsychologistCO
Clinical Social WorkerVA
Nurse PractitionerCO
P S Y C H I A T R YPA
Clinical Social WorkerCO
Clinical Social WorkerCO
Nurse PractitionerGA
Clinical Social WorkerCO
Nurse PractitionerTX

Reviews

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Frequently asked questions

Where can patients find ANNA LISA CLARK (LISW, LICDC)'s NPI?
You can confirm ANNA LISA CLARK (LISW, LICDC) with NPI 1457376485; it appears in the national provider directory.
Is ANNA LISA CLARK (LISW, LICDC) active in the national directory?
ANNA LISA CLARK (LISW, LICDC)'s public NPI profile is in an active state.
Does ANNA LISA CLARK (LISW, LICDC) list a primary specialty?
If you are matching referrals, note Addiction (Substance Use Disorder) Counselor for ANNA LISA CLARK (LISW, LICDC). Clinical services aligned with this taxonomy classification.
What location metadata exists for ANNA LISA CLARK (LISW, LICDC)?
The page summarizes North Ridgeville, Ohio for ANNA LISA CLARK (LISW, LICDC); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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