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

Shanavier Clark

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1477044071

Shanavier Clark is a Clinical Social Worker in Gulfport, Mississippi. Qualified in 2017, 9 years ago. Practices with Coastal Family Health Center, Inc, a 48-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
9
Licensed in
MS
In the registry since
2018
Specialties on file
2

Practice location Address checks out

15024 Martin Luther King Jr Blvd
Gulfport, MS 39501-8306
Phone: (228) 864-0003
Fax: (228) 863-7917
Show map & directions

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

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence C11808 (MS)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1477044071
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 21, 2018
Last updated in NPPESNovember 24, 2025
Certification dateNovember 24, 2025

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 Coastal Family Health Center, Inc — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Gulfport