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

Andrea Clark

Individual provider Clinical Social Worker · NPI 1508649070

Andrea Clark is a Clinical Social Worker in Fort Wayne, Indiana. Qualified in 2020, 6 years ago. Registered with an NPI since 2023.

Years since qualifying
6
In the registry since
2023

Practice location Address checks out

1530 Vance Ave
Fort Wayne, IN 46805-2246
Phone: (260) 200-3988
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1508649070
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 17, 2023
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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