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

Mr. Justin Blake Clark, LICSW

Individual provider Clinical Social Worker · NPI 1619458999

Mr. Justin Blake Clark, LICSW is a Clinical Social Worker in Seattle, Washington. Licensed in Washington. Registered with an NPI since 2018.

Licensed in
WA
In the registry since
2018
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1660 S Columbian Way Mailstop: (S-116)
Seattle, WA 98108
Phone: (206) 764-2007
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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 61139465 (WA)

Record details

NPI number1619458999
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedAugust 24, 2018
Last updated in NPPESAugust 5, 2022
Certification dateJuly 7, 2022

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