SHANDI MARIE CLARK LPC, ADC
NPI 1992410401
Counselor - Mental Health in Coos Bay, OR
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
Specialties & Licenses
Accepted 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
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.
Medicare Billing Reassignments
2Medicare enrollment records show Shandi Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Coos Bay, OR 97420
- Reassigned Medicare billing, Oregon enrollment
- 220 clinicians in this Medicare group
Ashland, OR 97520
- Reassigned Medicare billing, Oregon enrollment
- 35 clinicians in this Medicare group
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.
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.
Which organizations bill Medicare for Shandi Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shandi Clark reassigns Medicare benefits to 2 organizations: North Bend Medical Center Inc (Coos Bay, OR) and Rogue Psych Consultants, LLC (Ashland, OR). Each 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 Shandi Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shandi Clark accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan 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 37 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.
# Shandi Marie Clark, LPC, ADC · NPI 1992410401
Mental Health provider in Coos Bay, Oregon. Individual provider, active in the CMS NPPES registry since January 18, 2023.
## Identity
- **NPI:** 1992410401 (Entity type: Individual)
- **Enumerated:** January 18, 2023
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** C9599 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 1900 WOODLAND DR, Coos Bay, OR 97420-2099
- **Phone:** (541) 267-5151 · **Fax:** (541) 266-4554
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): North Bend Medical Center Inc (NPI 1063428308, Coos Bay, OR); Rogue Psych Consultants, LLC (NPI 1447727110, Ashland, OR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1992410401) · Data from the CMS NPPES public registry.