Janelle Elizabeth Clark, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2708-125 Issued in WI

Practice address

7861 State Road 60
Cedarburg, WI 53012-9305

Phone

(262) 546-1050

Fax

(262) 546-1051

NPI assigned

Sep 11, 2006

Sex

Female

Sole proprietor

No

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.

• Midwest Rehabilitation Associates, S.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wauwatosa, WI
  • NPI 1598877375

  Professional

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 7, 2023.

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1043314040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7861 STATE ROAD 60",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129305",
            "telephone_number": "262-546-1050",
            "fax_number": "262-546-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7861 STATE ROAD 60",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129305",
            "telephone_number": "262-546-1050",
            "fax_number": "262-546-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANELLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2708-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX IDENTIFICATION",
            "identifier": "391706314",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID/NPI#",
            "identifier": "1043314040",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21280000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Children'S Medical Group
• Chiropractic Company - Cedarburg LTD
• Sara Beck Cincotta, MS-CCC-SLP
• City of Cedarburg
• City of Newcastle
• Nicole Cofta
• Madyson Bellarose Contreras-Perrin, LPC-IT
• County of Ozaukee
• Laura Egan Cutler, M.A. CCC-SLP
• Daniel C Garcia DDS LLC

• All providers in Cedarburg, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.