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

Mary Watson Clark, LICSW, LMSW

Individual provider Clinical Social Worker · NPI 1720127988

Mary Watson Clark, LICSW, LMSW is a Clinical Social Worker in Minneapolis, Minnesota. Licensed in Michigan and Minnesota. Registered with an NPI since 2007.

Licensed in
MI, MN
In the registry since
2007
Specialties on file
3
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

410 Church St SE
Minneapolis, MN 55455-0222
Phone: (612) 625-8400
Fax: (612) 677-3211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 21255 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6801066900 (MI)
Social Worker Taxonomy 104100000X · Licence 6801066900 (MI)

Record details

NPI number1720127988
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW , LMSW
Sole proprietorNo
NPI enumeratedFebruary 5, 2007
Last updated in NPPESDecember 30, 2025
Certification dateDecember 30, 2025

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