Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Adam Clark, LCSW

Individual provider Clinical Social Worker · NPI 1699276287

Adam Clark, LCSW is a Clinical Social Worker in Coquille, Oregon. Qualified in 2014, 12 years ago. Practices with Waterfall Clinic Incorporated, a 17-clinician group and works from 2 locations. Licensed in Colorado and Oregon.

Years since qualifying
12
Licensed in
CO, OR
In the registry since
2018
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

790 E 5th St
Coquille, OR 97423-1755
Phone: (541) 396-3111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 66895 West St, Bend, OR 97703-9282 — (541) 668-7683

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L8122 (OR)
Clinical Social Worker Taxonomy 1041C0700X · Licence CSW.09924908 (CO)

Record details

NPI number1699276287
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedFebruary 28, 2018
Last updated in NPPESSeptember 3, 2020
Certification dateSeptember 3, 2020
Mailing address940 E 5th St, Coquille, OR 97423-1699

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Waterfall Clinic Incorporated — 17 clinicians
Accepts Medicare assignment Not indicated

Other providers in Coquille