Rebecca Erde Clark, LMFT-C

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

XM2762 Issued in ME

Practice address

80 River Rd
Newcastle, ME 04553-3838

Phone

(207) 563-3366

Fax

(207) 563-3393

NPI assigned

Feb 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Rebecca Erde Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 10, 2024 through Feb 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19131/brand/1/csg/1/fhir/r4

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

• Lifespan Family Healthcare LLC

  • Family Medicine Physician
  • Newcastle, ME
  • NPI 1598741399
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063549772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "NEWCASTLE",
            "state": "ME",
            "postal_code": "045530297",
            "telephone_number": "207-563-3366",
            "fax_number": "207-563-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 RIVER RD",
            "city": "NEWCASTLE",
            "state": "ME",
            "postal_code": "045533838",
            "telephone_number": "207-563-3366",
            "fax_number": "207-563-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECCA",
        "middle_name": "ERDE",
        "name_prefix": "Mrs.",
        "credential": "LMFT-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ME",
            "license": "XM2762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ERDE",
            "prefix": "MISS",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Rigg Atwood
• Susan M. Batchelor, LCSW
• Jacqueline Alana Cygnus Belknap, LCSW
• Michael H. Clark, M.D.
• Patricia Corscaden, LMT
• Lydia Crafts, LCSW
• Robert Morrison Dewitt Jr., D.D.S.
• Steven E. Feder, D.O.
• Angela Hassenpflug, LCPC

• Marriage & Family Therapist in Newcastle, ME
• Providers in Newcastle, ME by specialty
• Marriage & Family Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.