David Mack Clark

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401224555 Issued in MI

Practice address

1239 76TH St SW Ste H4
Byron Center, MI 49315-7921

Phone

(616) 258-6270

NPI assigned

Mar 29, 2016

Last updated

Apr 1, 2026By the provider in NPPES

Sex

Male

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

Enrolled in OK, MI2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Laureate Psychiatric Clinic and Hospital IncGroup PAC ID 3971599218, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Laureate Psychiatric Clinic and Hospital Inc

  • Psychiatric Hospital
  • Tulsa, OK
  • NPI 1710985064
  Medicare reassignment Care Compare group NPD
• Grand Rapids Counseling and Consultation LLC

  • Counselor
  • Byron Center, MI
  • NPI 1205544087
  Medicare reassignment NPD
• Grand Rapids Counseling and Consultation

  • Professional Counselor
  • Byron Center, MI
  • NPI 1306554282
  NPD
• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD (past)

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1215390265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 HARVEST HOME DR",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 76TH ST SW STE H4",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493157921",
            "telephone_number": "616-258-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741363326",
            "country_code": "US",
            "telephone_number": "918-491-3700",
            "fax_number": "918-481-4063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 S Holly St",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "727613304",
            "country_code": "US",
            "telephone_number": "479-524-8618",
            "fax_number": "479-750-4843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "MACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401224555",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401224555",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "12387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Camp, DPT
• Justin Edward Carroll, AT,ATC, CSCS
• Timothy Cassity
• Jeffery Lee Chamberlain, M.D.
• Christopher Powell, DDS Pediatric Dentistry, PLLC (Stellar Smiles Pediatric Dentistry)
• Brendan Clifford, PHARMD
• Neil Colegrove, MD
• Christopher Hayes Coller, D.O.
• Keith A Combs, DDS
• Connections Counseling & Education PLC

• Mental Health Counselor in Byron Center, MI
• Providers in Byron Center, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.
• 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.