Connie Lynn Clark, M.S.ED., LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.006792 Issued in IL

Practice address

955 S Durkin Dr
Ste. B
Springfield, IL 62704-1370

Phone

(217) 753-1288

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226102400000",
    "number": "1205913191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 S DURKIN DR",
            "address_2": "STE. B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041370",
            "telephone_number": "217-753-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S DURKIN DR",
            "address_2": "STE. B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041370",
            "telephone_number": "217-753-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.S.ED., LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.006792",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.006792",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.006792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Clancy
• McKenzie Kay Clanton
• Jude Anne Clapper, MS RD LDN CDE
• Abigail Clark
• Andrew Clark, O.D.
• Kelsey Jo Clark, CRNA
• Melissa Gayle Clark, PA-C
• Michelle Marie Clark, M.S., CCC-SLP
• Ted Robert Clark, M.D., M.P.P.
• Cathy L. Clausen, M.D.

• Professional Counselor in Springfield, IL
• Providers in Springfield, 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 8, 2008; 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.