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

Krystal Clark

Individual provider Clinical Social Worker · NPI 1346988441

Krystal Clark is a Clinical Social Worker in Ellijay, Georgia. Qualified in 2017, 9 years ago. Practices with Lifesource of North Carolina, a 170-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2022

Practice location Address checks out

917 Parker Rd
Ellijay, GA 30536-7957
Phone: (678) 357-7224
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CSW008048 (GA)

Record details

NPI number1346988441
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 26, 2022
Last updated in NPPESMay 26, 2022
Certification dateMay 26, 2022
Mailing address917 Parker Rd, Ellijay, GA 30536-7957

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Lifesource Of North Carolina — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ellijay