MR. JUSTIN BLAKE CLARK (NPI# 1619458999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619458999 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN BLAKE CLARK |
| Credential | MSW |
| Practice Address |
9600 Veterans Dr. Mailstop: Mhc 61-116-c Tacoma WA 98493-5000 |
| Mailing Address |
2321 14th Ave S Apt 1 Seattle WA 98144-5099 |
| Practice Telephone | 2535832554 |
| Mailing Telephone | 6145106993 |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493226 | Justin Clark | Student in an Organized Health Care Education/Training Program | 7337 Wythe Dr, Noblesville, IN 46062-7785 | 2020-10-08 |
| 1942531868 | Justin Clark | Pharmacist | 12050 N Dove Mt Blvd, Marana, AZ 85658 | 2010-01-15 |
| 1750528964 | Justin Liam Clark | Physical Therapist | 102 Fairview Pk Dr, Elmsford, NY 10523-1518 | 2009-01-09 |
| 1598945644 | Justin Charles Clark | Neurological Surgery | 414 Plymouth Ne, Grand Rapids, MI 49505-6041 | 2007-11-06 |
| 1538129085 | Justin Clark | Allergy & Immunology | 362 Beal Pkwy Nw Ste 105, Fort Walton Beach, FL 32548-3926 | 2006-03-27 |
| 1639164098 | Justin Wayne Clark | Dermatology | 3601 22nd St, Lubbock Dermatology, Lubbock, TX 79410-1309 | 2005-09-13 |
| 1912483645 | Justin D Clark | Social Worker | 533 26th St Ste 100, Ogden, UT 84401-2459 | 2018-07-16 |
| 1235621327 | Justin M Clark | Family Medicine | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2018-06-04 |
| 1760987481 | Justin Clark | Occupational Therapist | 14151 15 Mile Rd, Sterling Heights, MI 48312-5507 | 2018-03-26 |
| 1285136846 | Justin Clark | Orthotist | 1844 South St, Redding, CA 96001-1809 | 2018-02-28 |
| Street Address |
9600 VETERANS DR. MAILSTOP: MHC 61-116-C |
| City | TACOMA |
| State | WA |
| Zip Code | 98493-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134480809 | Veterans Affairs | Clinic/Center | 9600 Veterans Dr., Tacoma, WA 98498 | 2012-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508389032 | Alina Pechko | Optometrist | 9600 Veterans Dr Sw Bldg 6, Tacoma, WA 98493 | 2017-07-17 |
| 1326290305 | Margaret Elizabeth Johnston-grysho | Social Worker | 9600 Veterans Dr Sw Bldg 148, Tacoma, WA 98493 | 2008-10-21 |
| 1811195126 | Jerry J Thomas | Psychiatry & Neurology | Va Puget Sound Health Care System, American Lake Divisi, 9600 Veterans Drive Southwest, Buidling 61, Tacoma, WA 98493 | 2007-07-08 |
| 1043372873 | Tomi Thompson Dominguez | Social Worker | 9600 Veteran's Drive Sw Bldg 61 Room 136, Puget Sound Va- American Lake Division, Tacoma, WA 98493 | 2006-12-15 |
| 1669555397 | Amor G Carethers | Registered Nurse | Va Puget Sound Anerican Lake Division, 9600 Veterans Drive, Lake Wood, WA 98493 | 2006-10-24 |
| 1295818144 | Kimha Thi Vu | Registered Nurse | 9600 Veteran Dr., Lakewood, WA 98493 | 2006-10-23 |
| 1952496226 | Cathy Ann Sorem | Registered Nurse | 9600 Veterans Drive A116-r, Bldg. 61a, Room 123, Tacoma, WA 98493 | 2006-10-04 |
| 1831285527 | Ann Christine Uppenberg-liedtke | Nurse Practitioner | Puget Sound Health Care Systems, American Lake, 9600 Veterans Drive, Tacoma, WA 98493 | 2006-10-04 |
| 1972695948 | Charlene Howard | Social Worker | 9600 Veteran Drive, Tacoma, WA 98493 | 2006-09-28 |
| 1376635201 | Judith Sandra Schainen | Nurse Practitioner | 9600 Veterans Way South, Va Puget Sound Health Care System, Tacoma, WA 98493 | 2006-09-28 |
| Find all providers in zip 98493 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827551 | Heidi Elizabeth Hartz | Social Worker | 9040 Jackson Ave Joint Base Lewis-mcchord, Tacoma, WA 98431-0001 | 2020-10-08 |
| 1184241556 | Michele Therese Peyton | Social Worker | 4652 E Q St, Tacoma, WA 98404-4528 | 2020-07-01 |
| 1689293433 | Zowa Saysan Thompson | Social Worker | 4847 S 7th St, Tacoma, WA 98405-1206 | 2020-04-12 |
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1740826593 | Kerry Ann Shaughnessy | Social Worker | 3516 S 47th St Ste 203, Tacoma, WA 98409-4475 | 2019-11-26 |
| 1669039897 | Katherine Marie Ginn | Social Worker | 1402 S 11th St, Tacoma, WA 98405-3608 | 2019-05-22 |
| 1285112763 | Sheri Lynn Waller | Social Worker | 535 Dock St Ste 108, Tacoma, WA 98402-4629 | 2018-08-06 |
| 1003312612 | Jennifer I. Soto | Social Worker | 1432 N Baltimore St, Tacoma, WA 98406-2702 | 2018-04-03 |
| 1295233955 | Lori A Jensen | Social Worker | 317 M.l.k. Jr Way, Tacoma, WA 98405 | 2018-01-29 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.