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

MS. Vivian Audrey Clark, LCSW, LISW-CP

Individual provider Clinical Social Worker · NPI 1811229362

MS. Vivian Audrey Clark, LCSW, LISW-CP is a Clinical Social Worker in Charlotte, North Carolina. Qualified in 2008, 18 years ago. Practices with Capitolhill Consortium for Counseling and Consultation, LLC, a 19-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina and South Carolina.

Years since qualifying
18
Licensed in
NC, SC
In the registry since
2010
Specialties on file
4
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1935 J N Pease Pl Ste 101
Charlotte, NC 28262
Phone: (704) 907-8242
Fax: (704) 973-0694
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10211 Meridale Crossing Dr, Charlotte, NC 28269-7367 — (704) 907-8242

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C009292 (NC)
Clinical Social Worker Taxonomy 1041C0700X · Licence SW.11115CP (SC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 2850-A (NC)
Clinical Social Worker Taxonomy 1041C0700X

Record details

NPI number1811229362
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , LISW-CP
Sole proprietorYes
NPI enumeratedFebruary 9, 2010
Last updated in NPPESAugust 8, 2023
Certification dateAugust 8, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Capitolhill Consortium For Counseling And Consultation, Llc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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