Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Melissa Clark, 6002172

Individual provider Clinical Social Worker · NPI 1801967195

Melissa Clark, 6002172 is a Clinical Social Worker in Columbus, Indiana. Graduated from State University of New York at Buffalo School of Medicine in 1997, 29 years ago. Practices with Saint Peter's Lutheran Church, a 6-clinician group and accepts Medicare assignment. Licensed in Indiana and North Carolina.

Years since qualifying
29
Trained at
State University of New York at Buffalo School of Medicine
Licensed in
IN, NC
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

6141 Basswood Dr
Columbus, IN 47201-8431
Phone: (812) 603-6827
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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 34005724A (IN)
Clinical Social Worker Taxonomy 1041C0700X · Licence C003571 (NC)

Record details

NPI number1801967195
Entity typeIndividual (Type 1)
GenderFemale
Credentials 6002172
Sole proprietorNo
NPI enumeratedNovember 10, 2006
Last updated in NPPESMarch 30, 2016
Mailing address719 5th St, Columbus, IN 47201-6306

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduated 1997 (29 years in practice)
Group practice Saint Peter'S Lutheran Church — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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