Courtney Marie Clark, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7192-125 Issued in WI

Practice address

833 N 26TH St
Milwaukee, WI 53233-1507

Phone

(414) 345-6386

NPI assigned

Nov 20, 2018

Last updated

Nov 20, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Penfield Children's Center, Inc.

  • Clinic/Center
  • Milwaukee, WI
  • NPI 1275692410
  NPD (past)

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1275002164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 17TH AVE",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530242030",
            "telephone_number": "715-966-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 N 26TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331507",
            "telephone_number": "414-345-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7192-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarity Home Health Care LLC
• Amanda Clark-Krause, NP
• Ajani Shakir Clark
• Anaddia S Clark
• Candace Ann Clark, PA
• Delna Lee Clark, LPN
• Grant Brierton Clark
• Kenneth Clark, M.D.
• Lindsey Margaret Clark, PHARM.D.
• Nicole Clark, APSW, CSAC

• Professional Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.