Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TINA DENICE CLARK LCSW
NPI 1063857076
Social Worker - Clinical in Jonesboro, AR

Q: What is Tina Clark's NPI number?

The NPI number for Tina Clark is 1063857076. It was assigned to this individual provider in the NPPES registry on May 3, 2013.

Q: What is Tina Clark's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Tina Clark was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 03, 2013PECOS EnrolledAccepts Medicare Assignment

2712 E JOHNSON AVE, JONESBORO, AR 72405(870) 932-2800(870) 932-1189 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 2, 2026, Aug 5, 2025, Aug 10, 2016 (3 updates tracked since 2016).

On this page

About Tina Denice Clark Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TINA DENICE CLARK LCSW (NPI 1063857076) is an individual clinical provider in Jonesboro, Arkansas, licensed in Arkansas (7038-C) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1063857076

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameTINA DENICE CLARKCredential: LCSW

Location Address2712 E JOHNSON AVEJonesboro, AR 72405-1874

Mailing Address2712 E Johnson AveJonesboro, AR 72405-1874 · (870) 932-2800

Phone(870) 932-2800

Fax(870) 932-1189

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMay 3, 2013

Last NPPES UpdateSeptember 2, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2026

✔ NPI 1063857076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in AR · 7038-C

Definition

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.

Also ListedSocial WorkerTaxonomy 104100000X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

2712 E JOHNSON AVE, Jonesboro, AR 72405

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Secondary Practice Locations 2

Location 1837 Willett RoadJonesboro, AR 72401 · Phone (870) 393-5335

Location 2615 E Matthews AveJonesboro, AR 72401-3145 · Phone (870) 930-9090

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tina Denice Clark Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214430750

PECOS Enrollment IDI20250911002546

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tina Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Bernards Hospital Inc

Same address

General Acute Care Hospital

2712 E JOHNSON AVE
Jonesboro, AR 72401

Reassigned Medicare billing, Arkansas enrollment
79 clinicians in this Medicare group

NPI 1346301306 (870) 932-2800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $51.36 – $157.74

Typical copayment $0.00 (range $12.84 – $39.43)

Most-billed visit code NA

Established Patient

$64.56 typical visit price

range $16.16 – $128.77

Typical copayment $16.14 (range $4.04 – $32.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARMEN L BOYD LCSW

Social Worker (Clinical)