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MRS. CAITLIN VAN CLARK LCSW
NPI 1639703887
Social Worker - Clinical in Roseburg, OR

Active since February 26, 2020PECOS Enrolled
621 W MADRONE ST, ROSEBURG, OR 97470(541) 672-2691 Get Directions Write a Review

NPPES record last updated: February 27, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 12, 2024, Apr 4, 2024, Jul 19, 2023 and 1 more (4 updates tracked since 2020).

About Mrs. Caitlin Van Clark Lcsw NPPES

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

MRS. CAITLIN VAN CLARK LCSW (NPI 1639703887) is an individual clinical provider in Roseburg, Oregon, licensed in Oregon (L11752) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Springfield.

NPPES Registry Identity

NPI1639703887
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. CAITLIN VAN CLARKCredential: LCSW
Location Address621 W MADRONE STRoseburg, OR 97470-3090
Mailing AddressPo Box 1121Roseburg, OR 97470-0254
Phone(541) 672-2691
Sole ProprietorNo
Enumeration DateFebruary 26, 2020
Last NPPES UpdateFebruary 27, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2026
✔ NPI 1639703887 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 OR · L11752
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 ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 21-QMHP-R-0533 (OR)
621 W MADRONE ST, Roseburg, OR 97470
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Secondary Practice Location 1

Location 1568 Ethan CtSpringfield, OR 97477-9407 · Phone (541) 503-8925

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Caitlin Van Clark Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

Adapt
Same address
Community/Behavioral Health
621 W MADRONE ST
Roseburg, OR 97470
  • Reassigned Medicare billing, Oregon enrollment
  • 83 clinicians in this Medicare group
NPI 1639682883 (541) 492-0241

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97470 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 $54.96 – $166.64
Typical copayment $0.00 (range $13.74 – $41.66)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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 20

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

WILLIAM F SHOBE JR. LMFT
Marriage & Family Therapist
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 492-4550
HEATHER IRENE JOHNSON MSW
Social Worker
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532
URIAH HEATH YRAGUEN
Peer Specialist
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MR. DALE EDWARD WILLIAMS MC, LPC
Counselor (Mental Health)
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532
EMILY TUCKER LPC NCC
Counselor (Professional)
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
INGER C BOYD MA ED., BS
Counselor
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532
MAE L HOOPES
Counselor (Addiction (Substance Use Disorder))
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
JENNIFER DIANE LOWRY
Counselor (Mental Health)
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532

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 Caitlin Clark's NPI number?

The NPI number for Caitlin Clark is 1639703887. It was assigned to this individual provider in the NPPES registry on February 26, 2020.

Where is Caitlin Clark located?

Caitlin Clark practices at 621 W Madrone St, Roseburg, OR 97470. The listed phone number is (541) 672-2691.

What is Caitlin Clark's specialty?

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

Is Caitlin Clark enrolled in Medicare?

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

Which organization bills Medicare for Caitlin Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Caitlin Clark reassigns Medicare benefits to Adapt (Roseburg, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Caitlin Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Caitlin Clark accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Caitlin Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Caitlin Clark was last updated on February 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.