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LEACHA M CLARK ASW
NPI 1366187676
Social Worker - Clinical in Ione, CA

Active since May 02, 2022PECOS Enrolled

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Leacha M Clark Asw NPPES

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

LEACHA M CLARK ASW (NPI 1366187676) is an individual clinical provider in Ione, California, licensed in California (131925) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1366187676
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameLEACHA M CLARKCredential: ASW
Location Address4001 CA-104Ione, CA 95640
Mailing Address4380 Bastille WalkSacramento, CA 95834-2122 · (209) 687-1754
Phone(209) 274-4911
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMay 2, 2022
Last NPPES UpdateAugust 29, 2025
NPPES CertifiedAugust 29, 2025
✔ NPI 1366187676 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 CA · 131925
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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 106588 (CA)
4001 CA-104, Ione, CA 95640
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Leacha M Clark Asw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305321035
PECOS Enrollment IDI20260331003243
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 95640 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 $58.87 – $176.60
Typical copayment $0.00 (range $14.71 – $44.15)
Most-billed visit code NA
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
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 7

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

YOSELIN ELIZABETH ORTIZ-LUNA
Social Worker (Clinical)
4001 CA-104
IONE, CA 95640
Amador County (209) 274-4911
SAM KANE HARARY PSYCHOLOGIST
Psychologist
4001 CA-104
IONE, CA 95640
Amador County (209) 274-4911
DR. FELICITY M GAZOWSKY PSYD
Psychologist (Clinical)
4001 CA-104
IONE, CA 95640
Amador County (209) 274-4911
DR. HOLLY DIANE PARKS PSYD
Psychologist (Clinical)
4001 CA-104
IONE, CA 95640
Amador County (916) 662-6544
DR. MADALINE LOMIBAO PSY.D
Psychologist (Clinical)
4001 CA-104
IONE, CA 95640
Amador County (209) 274-4911
DR. ROBERT CHARLES ARNOLD PH.D.
Psychologist (Clinical)
4001 CA-104
IONE, CA 95640
Amador County (209) 274-4911
SARAH CORINNE MARTIN
Counselor (Mental Health)
4001 CA-104
IONE, CA 95640
Amador County (209) 274-4911

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 Leacha Clark's NPI number?

The NPI number for Leacha Clark is 1366187676. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Where is Leacha Clark located?

Leacha Clark practices at 4001 Ca-104, Ione, CA 95640. The listed phone number is (209) 274-4911.

What is Leacha Clark's specialty?

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

Is Leacha Clark enrolled in Medicare?

Yes. Leacha Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leacha Clark was last updated on August 29, 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.