KIMBERLY R CLARK MSW
NPI 1861786790
Social Worker in Sylvania, OH

Q: What is Kimberly Clark's NPI number?

The NPI number for Kimberly Clark is 1861786790. It was assigned to this individual provider in the NPPES registry on June 8, 2011.

Q: What is Kimberly Clark's specialty?

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

Q: Is Kimberly Clark enrolled in Medicare?

No. Kimberly Clark has opted out of Medicare through April 16, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Clark was last updated on June 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 June 08, 2011Opted out of Medicare · through Apr 16, 2028

5465 MAIN ST, SYLVANIA, OH 43560(419) 885-8800(419) 885-8600 Get Directions Write a Review

NPPES record last updated: June 8, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kimberly R Clark Msw NPPES

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

KIMBERLY R CLARK MSW (NPI 1861786790) is an individual social worker in Sylvania, Ohio, licensed in Ohio (S1100497) and active in the NPI registry since June 2011. She has opted out of Medicare through April 16, 2028.

NPPES Registry Identity

NPI1861786790

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameKIMBERLY R CLARKCredential: MSW

Location Address5465 MAIN STSylvania, OH 43560-2155

Mailing Address5465 Main StSylvania, OH 43560-2155 · (419) 885-8800 · Fax (419) 885-8600

Phone(419) 885-8800

Fax(419) 885-8600

Sole ProprietorNo

Enumeration DateJune 8, 2011

✔ NPI 1861786790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in OH · S1100497

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.

5465 MAIN ST, Sylvania, OH 43560

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Kimberly R Clark Msw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 16, 2024 through April 16, 2028.

Opt-Out Effective DateApril 16, 2024

Opt-Out In Effect ThroughApril 16, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 15

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

KIMBERLY PORTER MOSLEY RN

Registered Nurse