Individual provider · Type 1 NPI

Patrick Michael Clark, LMSW

Clinical Social Worker · Waterloo, NY

NPI number 1104513506 Active

Practice location

31 Thurber Dr
Waterloo, NY 13165-1665

Call (315) 539-1980 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700X29834 (MN)
Clinical Social Worker Primary 1041C0700X128055-01 (NY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104513506

Patrick Michael Clark, LMSW's National Provider Identifier is 1104513506, issued on Apr 18, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Waterloo, NY. The record was last updated on Aug 25, 2025.