Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHANDI MARIE CLARK LPC, ADC
NPI 1992410401
Counselor - Mental Health in Coos Bay, OR

Active since January 18, 2023PECOS Enrolled
1900 WOODLAND DR, COOS BAY, OR 97420(541) 267-5151(541) 266-4554 Get Directions Write a Review

NPPES record last updated: September 30, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Sep 30, 2026, Jan 21, 2026, Jan 18, 2023 (3 updates tracked since 2023).

About Shandi Marie Clark Lpc, Adc NPPES

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

SHANDI MARIE CLARK LPC, ADC (NPI 1992410401) is an individual mental health provider in Coos Bay, Oregon, licensed in Oregon (C9599) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1992410401
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHANDI MARIE CLARKCredential: LPC, ADC
Location Address1900 WOODLAND DRCoos Bay, OR 97420-2099
Mailing Address1900 Woodland DrCoos Bay, OR 97420-2099 · (541) 267-5151 · Fax (541) 266-4554
Fax(541) 266-4554
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 18, 2023
Last NPPES UpdateSeptember 30, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2026
✔ NPI 1992410401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · C9599
1900 WOODLAND DR, Coos Bay, OR 97420

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shandi Marie Clark Lpc, Adc 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 ID7214420025
PECOS Enrollment IDI20251201002758
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.

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.

Physical Therapist
1900 WOODLAND DR
COOS BAY, OR 97420
Physical Therapist
1900 WOODLAND DR
COOS BAY, OR 97420
Internal Medicine
1900 WOODLAND DR
COOS BAY, OR 97420
Pediatrics
1900 WOODLAND DR
COOS BAY, OR 97420
Pharmacist
1900 WOODLAND DR, SUITE A
COOS BAY, OR 97420
Surgery (Plastic and Reconstructive Surgery)
1900 WOODLAND DR
COOS BAY, OR 97420
Pediatrics
1900 WOODLAND DR
COOS BAY, OR 97420
Physician Assistant
1900 WOODLAND DR
COOS BAY, OR 97420

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 Shandi Clark's NPI number?

The NPI number for Shandi Clark is 1992410401. It was assigned to this individual provider in the NPPES registry on January 18, 2023.

Where is Shandi Clark located?

Shandi Clark practices at 1900 Woodland Dr, Coos Bay, OR 97420. The listed phone number is (541) 267-5151.

What is Shandi Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Shandi Clark enrolled in Medicare?

Yes. Shandi Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shandi Clark accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Shandi 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 Shandi Clark was last updated on September 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.