Alyssa B Clark

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

6570 Sosna Dr
Fairfield, OH 45014-2222

Phone

(513) 942-4673

NPI assigned

Oct 9, 2023

Sex

Female

Sole proprietor

Yes

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.

• Decoach Team LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  NPD
• Decoach Team LLC

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2024.

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1124809983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 SOSNA DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142222",
            "telephone_number": "513-942-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALYSSA",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cincinnati Center for Autism
• Cincinnati Comprehensive Pain Center LLC
• Cincinnati Hematology-Oncology, Inc
• Cincy Care, Inc
• City of Fairfield
• Kristal Renee Clark, LPN
• Taronda Clark, AUD
• Clarkson Optometry Midwest Inc
• Clearview Counseling Services, Inc.
• Charlene Clemons, LPN

• All providers in Fairfield, OH
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.