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

Shelley Lynn Clark, LICSW

Individual provider Clinical Social Worker · NPI 1063235992

Shelley Lynn Clark, LICSW is a Clinical Social Worker in Vancouver, Washington. Qualified in 2009, 17 years ago. Practices with Peacehealth, a 187-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
17
Licensed in
WA
In the registry since
2024
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

2513 NW 117th St
Vancouver, WA 98685-3667
Phone: (360) 991-6272
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1615 Delaware St, Longview, WA 98632-2367 — (360) 414-2091
  • 1718 E Kessler Blvd, Longview, WA 98632-1842 — (360) 747-5800

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW61516470 (WA)

Record details

NPI number1063235992
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedNovember 7, 2024
Last updated in NPPESDecember 10, 2024
Certification dateDecember 10, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Peacehealth — 187 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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