Michele J Clark, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003827 Issued in VA

Practice address

289 Independence Blvd
Ste 245
Virginia Beach, VA 23462-5493

Phone

(757) 385-0850

Fax

(757) 518-9713

NPI assigned

Aug 2, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of ChesapeakeGroup PAC ID 6204885601, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• City of Chesapeake

  • Community/Behavioral Health Agency
  • Chesapeake, VA
  • NPI 1073650099
  Medicare reassignment Care Compare group NPD
• City of Chesapeake

  • Ambulance
  • Chesapeake, VA
  • NPI 1659385938
  NPD

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1326326729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 ALMOND CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233235623",
            "telephone_number": "757-214-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 INDEPENDENCE BLVD",
            "address_2": "STE 245",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625493",
            "telephone_number": "757-385-0850",
            "fax_number": "757-518-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHELE",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861562472",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Clark, SLP
• Lindsay Clark, DPT
• Lisa M Clark
• Margaret Ann Clark
• Meridith Elaine Clark, LPTA
• Midajee Clark
• Paulette Elaine Clark
• Valerie Jordan Clark, LPC
• Yolanda Cheryl Clark, D.D.S.
• April L Clarke, LCSW

• Professional Counselor in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.