Lasheena J. Clark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.012484 Issued in IL

Practice address

1448 N Milwaukee Ave Ste 201
Chicago, IL 60622-9225

Phone

(312) 476-9064

NPI assigned

Jun 5, 2009

Sex

Female

Sole proprietor

No

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 IL

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primecare Community Health, Inc.Group PAC ID 6204722077, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lasheena.clark.1@16494.direct.athenahealth.com

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.

• Primecare Community Health, Inc.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1558532739
  Medicare reassignment Care Compare group NPD
• Primecare Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1891541215
  NPD
• Primecare Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1225010911
  NPD
• Willis Healthcare Inc

  • In Home Supportive Care Agency
  • Chicago, IL
  • NPI 1063157527
  NPD
• Primecare Community Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1790247476
  NPD (past)

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1093941957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 N MILWAUKEE AVE STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606229225",
            "telephone_number": "312-476-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 N MILWAUKEE AVE STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606229225",
            "telephone_number": "312-476-9064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5341 W Cermak Rd",
            "address_purpose": "LOCATION",
            "city": "Cicero",
            "state": "IL",
            "postal_code": "608042817",
            "country_code": "US",
            "telephone_number": "708-656-6430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LASHEENA",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.012484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Clark, MD
• Karli Clark
• Kasandria Clark, MD
• Keisha Ann Clark
• Kelly Jo Clark, PT
• Laurel Maxyne Clark, M.D.
• Lisa P Clark, RD,LDN, CNSC
• Marcus Clark
• Margaret Harrigan Clark, M.A.
• Marlena Clark, PHD

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.