Jenna Michelle Johnson-Clark, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3313 Issued in MN

Practice address

1205 Grand Ave
Saint Paul, MN 55105-2634

Phone

(317) 607-2121

NPI assigned

Apr 21, 2025

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

• Jenna Clark Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Invigorate Life Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1508107541
  Medicare reassignment NPD

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1083401517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 HAZEL ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194227",
            "telephone_number": "317-607-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052634",
            "telephone_number": "317-607-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-CLARK",
        "first_name": "JENNA",
        "middle_name": "MICHELLE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John W Benton MD PA
• Paulose S John, M.D
• Christine L Johns, MD
• James W Johns, LICSW
• Erica Lynn Johnsen, PHD, LP
• Michelle Marie Johnson-Dupre, LPC
• Amy Elizabeth Johnson-Grass, ND, LM, LN, CPM
• Eada Johnson-Raab, SPEECH-LANGUAGE PATH
• Jennifer Johnson-Schmidt, RRT
• Abimbola Johnson, DPM

• Mental Health Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.