Individual provider Active NPI

Aubrey Lynn Clark

  • Counselor
  • Toledo, OH
National Provider Identifier
1073161709
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
6629 W Central Ave
Toledo, OH 43617-1098
Phone
(419) 475-4449
NPI assigned
Aug 27, 2019
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

6629 W Central Ave
Toledo, OH 43617-1098

Mailing address

6629 W Central Ave
Toledo, OH 43617-1098
Phone (419) 475-4449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240315003705 OH Practitioner - Mental Health Counselor 1355787029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Behavioral Health Services LLCGroup PAC ID 2264502541, 16 clinicians

Practice addresses (Care Compare)

2770 Centennial Rd
Toledo, OH 43617-1829
Phone 4197940567122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Behavioral Health Services LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2770 Centennial Rd
Toledo, OH 43617
Phone (419) 794-0567

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1073161709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6629 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171098",
            "telephone_number": "419-475-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6629 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171098",
            "telephone_number": "419-475-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "AUBREY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.