PATRICK MICHAEL CLARK LMSW
NPI 1104513506
Social Worker - Clinical in Waterloo, NY

Active since April 18, 2023
31 THURBER DR, WATERLOO, NY 13165(315) 539-1980 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Patrick Michael Clark Lmsw NPPES

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

PATRICK MICHAEL CLARK LMSW (NPI 1104513506) is an individual clinical provider in Waterloo, New York, licensed in New York (128055-01) and active in the NPI registry since April 2023.

NPPES Registry Identity

NPI1104513506
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NamePATRICK MICHAEL CLARKCredential: LMSW
Location Address31 THURBER DRWaterloo, NY 13165-1665
Mailing Address31 Thurber DrWaterloo, NY 13165-1665 · (315) 539-1980
Sole ProprietorYes
Enumeration DateApril 18, 2023
Last NPPES UpdateAugust 25, 2025
NPPES CertifiedAugust 25, 2025
NPI 1104513506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses Licensed in NY · 128055-01 Licensed in MN · 29834
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.
31 THURBER DR, Waterloo, NY 13165

Other Providers at the Same Location NPPES 20

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

Case Manager/Care Coordinator
31 THURBER DR
WATERLOO, NY 13165
Registered Nurse
31 THURBER DR, SUITE 1
WATERLOO, NY 13165
Peer Specialist
31 THURBER DR
WATERLOO, NY 13165
Social Worker (Clinical)
31 THURBER DR
WATERLOO, NY 13165
Social Worker
31 THURBER DR
WATERLOO, NY 13165
Registered Nurse
31 THURBER DR
WATERLOO, NY 13165
Registered Nurse
31 THURBER DR
WATERLOO, NY 13165
Counselor (Mental Health)
31 THURBER DR
WATERLOO, NY 13165

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 Patrick Clark's NPI number?

The NPI number for Patrick Clark is 1104513506. It was assigned to this individual provider in the NPPES registry on April 18, 2023.

Where is Patrick Clark located?

Patrick Clark practices at 31 Thurber Dr, Waterloo, NY 13165. The listed phone number is (315) 539-1980.

What is Patrick Clark's specialty?

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

When was this NPI record last updated?

The NPPES record for Patrick Clark was last updated on August 25, 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.