MRS. JESSICA CLARK LCSW
NPI 1316542152
Social Worker - Clinical in Staten Island, NY

Q: What is Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1316542152. It was assigned to this individual provider in the NPPES registry on December 1, 2020.

Q: What is Jessica 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 Jessica Clark was last updated on January 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 December 01, 2020

3710 RICHMOND AVE, STATEN ISLAND, NY 10312(718) 967-0490 Get Directions Write a Review

NPPES record last updated: January 2, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 2, 2023, Dec 1, 2020 (2 updates tracked since 2020).

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About Mrs. Jessica Clark Lcsw NPPES

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

MRS. JESSICA CLARK LCSW (NPI 1316542152) is an individual clinical provider in Staten Island, New York, licensed in New York (094488) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1316542152

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. JESSICA CLARKCredential: LCSW

Location Address3710 RICHMOND AVEStaten Island, NY 10312-3848

Mailing Address36 Beacon AveStaten Island, NY 10306-1351 · (917) 697-3778

Phone(718) 967-0490

Sole ProprietorYes

Enumeration DateDecember 1, 2020

Last NPPES UpdateJanuary 2, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 2, 2023

✔ NPI 1316542152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NY · 094488

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 · License 101713 (NY)

3710 RICHMOND AVE, Staten Island, NY 10312

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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.

LAUREN VIGILANTE LMSW

Social Worker