Bridget Blake Clark, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005693 Issued in CT

Practice address

121 Ann St
Fairfield, CT 06824-5801

Phone

(203) 919-8677

NPI assigned

Aug 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bridget Clark Counseling LLC

  • Adult Mental Health Clinic/Center
  • Fairfield, CT
  • NPI 1548112196
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1245950633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 ANN ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245801",
            "telephone_number": "203-919-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 ANN ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245801",
            "telephone_number": "203-919-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRIDGET",
        "middle_name": "BLAKE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "005693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Anne Cisto, OTR/L
• Robert Bruce Citrin, PH.D.
• City Medical of Upper East Side, PLLC
• Brian Clancy
• Clarivision-Advanced Eye Care
• Courtney Clark, PSYD
• Todd L Clark, APRN
• Clean Rxeach LLC
• Clear Life Counseling and Wellness,PLLC
• Stephanie H Clines, PHD, LAT, ATC

• Mental Health Counselor in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.