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Deactivated NPI 1568570687 Deactivated / Inactive NPI Male Practitioner

Thomas Lawson Clark , LCSW

Social Worker - Clinical • Berkeley, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Thomas Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 28, 2006
NPI Deactivation Date April 07, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Thomas Clark, LCSW was a registered Social Worker - Clinical practicing in Berkeley, CA. Throughout an active medical career spanning 14 years, Thomas Clark provided care at the practice location at 2576 SHATTUCK AVE until profile deactivation on 2020-04-07.

Practice Location & Contact Primary Location

Practice Address

2576 Shattuck Ave

Berkeley, CA 94704

Telephone 5105486864

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker - Clinical in Berkeley, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.0 Yrs
State Avg: 18.1 Yrs
Regional Practice Density
301 Specialists

Practicing in Berkeley, CA (37073 Statewide)

Telehealth Adoption Rate
4.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Social Worker - Clinical Primary Specialty

NUCC Taxonomy Code: 1041C0700X

State License CA 5050

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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Ursula Anderson

Massage Therapist

NPI 1407637168
Aviva Wolman , MA

Marriage & Family Therapist

NPI 1447719943

Master of Arts

Dr. Susan Raeburn , PhD

Psychologist - Clinical

NPI 1821013475

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 07, 2020

Record deactivated on April 07, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2576 SHATTUCK AVE, BERKELEY, CA 94704 (Tel: 5105486864)

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Updated Business Mailing Address July 08, 2007

Registered at 1960 EL DORADO AVE, BERKELEY, CA 947072505 (Tel: 5105262609)

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Provider Name / Credentials Updated July 08, 2007

Recorded as THOMAS CLARK, LCSW

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Social Worker (License #5050 in CA)

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Initial NPI Registration & Enumeration August 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568570687
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 28, 2006
Last Update: July 08, 2007
Deactivation Date: April 07, 2020

Mailing Address

1960 El Dorado Ave

Berkeley, CA 947072505

Phone: 5105262609

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.