CLARK CUNNINGHAM-WHITE
NPI 1609525039
Social Worker in Holland, MI

Q: What is Clark Cunningham-white's NPI number?

The NPI number for Clark Cunningham-white is 1609525039. It was assigned to this individual provider in the NPPES registry on March 22, 2022.

Q: What is Clark Cunningham-white's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Active since March 22, 2022PECOS EnrolledAccepts Medicare Assignment

12265 JAMES ST, HOLLAND, MI 49424(616) 392-1873 Get Directions Write a Review

NPPES record last updated: March 22, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Clark Cunningham-white NPPES

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

CLARK CUNNINGHAM-WHITE (NPI 1609525039) is an individual social worker in Holland, Michigan and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1609525039

Entity TypeIndividualMale

Primary Taxonomy104100000X

Provider Legal NameCLARK CUNNINGHAM-WHITE

Location Address12265 JAMES STHolland, MI 49424-8613

Mailing Address12265 James StHolland, MI 49424-8613 · (616) 392-1873

Phone(616) 392-1873

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateMarch 22, 2022

NPPES CertifiedMarch 22, 2022

✔ NPI 1609525039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

12265 JAMES ST, Holland, MI 49424

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company, Priority Health.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

Clark Cunningham-white 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 ID7012433865

PECOS Enrollment IDI20250424002880

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 Clark Cunningham-white reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of Ottawa

Same address

Mental Health (Including Community Mental Health Center)

12265 JAMES ST
Holland, MI 49424

Reassigned Medicare billing, Michigan enrollment
28 clinicians in this Medicare group

NPI 1619932381 (616) 393-5600

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

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.

SHERYL ANN MASCORRO RN

Registered Nurse (Psychiatric/Mental Health, Child & Adolescent)