MARY KENLEY CLARK LICSW
NPI 1639053929
Social Worker - Clinical in Ponte Vedra Beach, FL
About Mary Kenley Clark Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY KENLEY CLARK LICSW (NPI 1639053929) is an individual clinical provider in Ponte Vedra Beach, Florida, licensed in Alabama (6365C) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
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.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Kenley Clark Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32082 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Mary Clark's NPI number?
The NPI number for Mary Clark is 1639053929. It was assigned to this individual provider in the NPPES registry on August 1, 2025.
Where is Mary Clark located?
Mary Clark practices at 310 S Ocean Grande Dr Unit 101, Ponte Vedra Beach, FL 32082. The listed phone number is (251) 422-2148.
What is Mary Clark's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Mary Clark enrolled in Medicare?
Yes. Mary Clark is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Mary Clark was last updated on August 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.
