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Frederick Clark

Case Manager/Care Coordinator β€’ Grand Rapids, MI

Active NPI 1922512607 Individual Practitioner Male Practitioner
Practice location in NPPES

3300 36th St Se
Grand Rapids, MI 495122810

Call 6168315660 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3300 36th St Se

Grand Rapids, MI 495122810

Telephone 6168315660
Organization at the Same NPPES Address or Phone
Wedgwood Christian Services Facility NPI 1215047667

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Grand Rapids and Michigan

273 active clinicians are listed under Case Manager/Care Coordinator with a practice address in Grand Rapids, MI (4,565 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Grand Rapids

0% of these 273 clinicians have the CMS telehealth indicator.

0% of these 273 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-03-13
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Behavior Technician

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
2910854 (OH)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location March 17, 2025

Registered at 3300 36TH ST SE, GRAND RAPIDS, MI 495122810 (Tel: 6168315660)

πŸ“
Updated Business Mailing Address March 17, 2025

Registered at 3300 36TH ST SE, GRAND RAPIDS, MI 495122810 (Tel: 6168315660)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2025

Behavior Technician

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2021

Case Manager/Care Coordinator

βœ…
NPI Profile Active November 17, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) November 17, 2017

Registered at 41521 W 11 MILE RD, NOVI, MI 483751803 (Tel: 8042446728)

πŸ“
Business Mailing Address (Initial Record) November 17, 2017

Registered at 1800 N MCCORD RD, TOLEDO, OH 436158702

πŸ‘€
Provider Name / Credentials (Initial Record) November 17, 2017

Recorded as FREDERICK CLARK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 17, 2017

Behavior Technician

🟒
Initial NPI Registration & Enumeration November 17, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1922512607
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 17, 2017
Last Update: March 17, 2025
Sole Proprietor: No

Mailing Address

3300 36th St Se

Grand Rapids, MI 495122810

Phone: 6168315660

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.