ROBERT MARC CLARK (LCSW LICENSED CLINIC) – Clinical Social Worker, NPI 1609932490

ROBERT MARC CLARK (LCSW LICENSED CLINIC) is a healthcare provider. based in Pendleton, Oregon. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW LICENSED CLINIC. They hold a License No. L0751 (OR). The NPI Number for ROBERT MARC CLARK (LCSW LICENSED CLINIC) is 1609932490

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT MARC CLARK (LCSW LICENSED CLINIC)
NPI
1609932490
Phone
(541) 276-4017
Address
200 SE HAILEY AVE
Enumeration Date
28 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5412764017
Graduation Year
1982 (44 years ago)
PAC ID
3870676323
Professional Enrollment ID
I20080207000268
Address ID
OR978011329PE615XXSTXX400
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

1,405 CLINICAL SOCIAL WORKER in OR

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Provider Addresses for ROBERT MARC CLARK (LCSW LICENSED CLINIC)

  • 200, Southeast Hailey Avenue, Pendleton, Umatilla County, Oregon, 97801, United States

    SUITE 301

    PENDLETON, OR 978011329

    Phone: (541) 276-4017

    Fax: (541) 278-3353

    Type: Location

  • 615 NW 7TH STR

    PENDLETON, OR 97801

    Phone: (541) 276-4017

    Fax: (541) 278-3353

    Type: Mailing

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: 2008-02-07

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
I20080207000268IClinical Social WorkerORTBD

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 97801)

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Reviews

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Frequently asked questions

What unique ID ties claims to ROBERT MARC CLARK (LCSW LICENSED CLINIC)?
NPI 1609932490 is assigned to ROBERT MARC CLARK (LCSW LICENSED CLINIC) under the national enumeration system.
Is ROBERT MARC CLARK (LCSW LICENSED CLINIC)'s NPI currently valid?
The extract we use shows ROBERT MARC CLARK (LCSW LICENSED CLINIC) as active.
What field does ROBERT MARC CLARK (LCSW LICENSED CLINIC) work in?
You can think of ROBERT MARC CLARK (LCSW LICENSED CLINIC) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is ROBERT MARC CLARK (LCSW LICENSED CLINIC)'s primary listing?
We display Pendleton, Oregon because that is what the record indicates for ROBERT MARC CLARK (LCSW LICENSED CLINIC).
How can I contact ROBERT MARC CLARK (LCSW LICENSED CLINIC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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