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

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: August 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

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 UpdateAugust 5, 20252 updates tracked since enumeration
NPPES CertifiedAugust 5, 2025
✔ 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 1615 E Matthews AveJonesboro, AR 72401-3145 · Phone (870) 930-9090
Location 2837 Willett RoadJonesboro, AR 72401 · Phone (870) 393-5335

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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)
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
RAVEN DON WEBER LMSW
Social Worker
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
LAURA HARMON LCSW
Social Worker (Clinical)
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
LINDSEY STACY APRN
Nurse Practitioner (Psychiatric/Mental Health)
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
DR. RICHARD WHITE D.O.
Psychiatry & Neurology (Psychiatry)
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
EMILY LIZETT JONES PLMSW
Social Worker
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
GWENDOLYN ROBERTS APRN
Nurse Practitioner (Psychiatric/Mental Health)
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800
PAULINE AKOTH NYALALA APRN
Nurse Practitioner (Psychiatric/Mental Health)
2712 E JOHNSON AVE
JONESBORO, AR 72405
Craighead County (870) 932-2800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Tina Clark located?

Tina Clark practices at 2712 E Johnson Ave, Jonesboro, AR 72405. The listed phone number is (870) 932-2800.

What is Tina Clark's specialty?

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

Is Tina Clark enrolled in Medicare?

Yes. Tina Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Tina Clark was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.