Darcie Rupert Clark, MS, LPCC, LCDCIII

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

EO8331 Issued in OH

Practice address

11 W Monument Ave Ste 100
Dayton, OH 45402-1293

Phone

(937) 679-6301

Fax

(937) 630-4391

NPI assigned

Sep 10, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Darcie R Clark LPCC LLCGroup PAC ID 3779958947, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Darcie R Clark LPCC LLC

  • Professional Counselor
  • Dayton, OH
  • NPI 1669842258

  Addiction (Substance Use Disorder), IN

  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1003149808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W MONUMENT AVE STE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021293",
            "telephone_number": "937-671-1589",
            "fax_number": "937-435-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W MONUMENT AVE STE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021293",
            "telephone_number": "937-679-6301",
            "fax_number": "937-630-4391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 Windsor Park Dr",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "45459",
            "country_code": "US",
            "telephone_number": "937-671-1589",
            "fax_number": "937-435-5865",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6239 Wilmington Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454597108",
            "country_code": "US",
            "telephone_number": "937-319-4448",
            "fax_number": "937-630-4391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DARCIE",
        "middle_name": "RUPERT",
        "name_prefix": "Mrs.",
        "credential": "MS, LPCC, LCDCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "991819",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "E08331-5",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "EO8331",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "EO8331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0184758",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• E. Darnel Clapp, PT
• Allison Clark, D.M.D.
• Arthur Columbus Clark III
• Carlie Clark, ATC, LAT, CES
• Cherie Lynn Clark, NP
• David E. Clark, R.D.
• Demetrius Rashaun Clark
• Donald Lester Clark, MD
• Elizabeth Ann Clark, DMD
• Ellen Yvette Clark

• Mental Health Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.