Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1275920233 Deactivated / Inactive NPI Male Practitioner

Clark Mitchell , LSW

Social Worker • Herrin, IL

⚠️

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, Clark Mitchell has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 16, 2015
NPI Deactivation Date March 29, 2023
Total Practice Duration ~8 Years of Practice (2015 – 2023)

Professional Overview & Biography Verified Profile Summary

Clark Mitchell, LSW was a registered Social Worker practicing in Herrin, IL. Throughout an active medical career spanning 8 years, Clark Mitchell provided care at the practice location at 3041 EDEN PARK DR until profile deactivation on 2023-03-29.

Practice Location & Contact Primary Location

Practice Address

3041 Eden Park Dr

Herrin, IL 629483717

Telephone 6186945175

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Herrin, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Herrin, IL (5960 Statewide)

Telehealth Adoption Rate
0.0% 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 Primary Specialty

NUCC Taxonomy Code: 104100000X

State License IL 150.015026

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Career & Practice History Timeline

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

7 Historical Events
⚠️
NPI Profile Deactivated March 29, 2023

Record deactivated on March 29, 2023

NPI Profile Active April 16, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location April 16, 2015

Registered at 3041 EDEN PARK DR, HERRIN, IL 629483717 (Tel: 6186945175)

📍
Updated Business Mailing Address April 16, 2015

Registered at 3041 EDEN PARK DR, HERRIN, IL 629483717 (Tel: 6186945175)

👤
Provider Name / Credentials Updated April 16, 2015

Recorded as CLARK MITCHELL, LSW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2015

Social Worker (License #150.015026 in IL)

🟢
Initial NPI Registration & Enumeration April 16, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Clark Mitchell. Be the first to share your experience!

Sign in to leave a review for Clark Mitchell

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1275920233
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 16, 2015
Last Update: April 16, 2015
Deactivation Date: March 29, 2023

Mailing Address

3041 Eden Park Dr

Herrin, IL 629483717

Phone: 6186945175

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.