Linda M Clark, MA, LPPC-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.1100179-SUPV Issued in OH

Practice address

4510 Dressler Rd NW
Canton, OH 44718-2546

Phone

(216) 450-1613

Fax

(216) 450-1614

NPI assigned

Jul 30, 2012

Last updated

Jan 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Recovery Concepts, LLCGroup PAC ID 5991005860, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Recovery Concepts LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1619348414

  Mental Health

  Medicare reassignment Care Compare group NPD
• Axis Mental Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Alliance, OH
  • NPI 1568349959
  NPD (past)

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1083960827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844020",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844020",
            "telephone_number": "216-450-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182546",
            "telephone_number": "216-450-1613",
            "fax_number": "216-450-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LINDA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA, LPPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1100179-SUPV",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1100179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Elizabeth Clark
• Ed J Clark, CRNA
• Janet S Clark
• Julie Clark
• Kurt S Clark
• Maurice Duron Clark, MD
• Midge Ann Clark, LPN
• Natalie Clark
• Ryan Clark, DO
• Tanaya Danielle Clark

• Mental Health Counselor in Canton, OH
• Providers in Canton, 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 Jan 2, 2024; 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.