Shanavier Clark, is a medicare enrolled "Social Worker" provider in Gulfport, Mississippi. She graduated from healthcare school in 2017 and has 9 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Coastal Family Health Center, Inc and her current practice location is
15024 Martin Luther King Jr Blvd, Gulfport, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(228) 864-0003.
Shanavier Clark is licensed to practice in Mississippi (license number C11808) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1477044071.
Healthcare Provider's Profile
| Full Name | Shanavier Clark |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 9 Years |
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| Location | 15024 Martin Luther King Jr Blvd, Gulfport, Mississippi |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shanavier Clark graduated from medical school in 2017
NPI Data:
- NPI Number: 1477044071
- Provider Enumeration Date: 05/21/2018
- Last Update Date: 11/24/2025
Medicare PECOS Information:
- PECOS PAC ID: 6002392503
- Enrollment ID: I20260114004034
Medical Identifiers
Medical identifiers for Shanavier Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477044071 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | C11808 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Coastal Family Health Center, Inc | 8628989654 | 45 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shanavier Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shanavier Clark,
10467 Corporate Dr,
Gulfport, MS 39503-4634
Ph: (228) 374-2494 | Shanavier Clark,
15024 Martin Luther King Jr Blvd,
Gulfport, MS 39501-8306
Ph: (228) 864-0003 |
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