Judith J Clark, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC000691 Issued in PA

Practice address

239 S Butler Rd
Lebanon, PA 17042-8939

Phone

(717) 273-8871

Fax

(717) 270-2452

NPI assigned

Nov 15, 2007

Last updated

Feb 1, 2023By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PhilhavenGroup PAC ID 8729991419, 93 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.

• Philhaven

  dba WellSpan Philhaven

  • Psychiatry Physician
  • Lebanon, PA
  • NPI 1043316441
  Medicare reassignment Care Compare group NPD
• Philhaven

  dba WellSpan Philhaven

  • Psychiatric Hospital
  • Lebanon, PA
  • NPI 1972598076
  NPD
• Samaritan Counseling Center

  • Psychologist
  • Lancaster, PA
  • NPI 1043274608

  Professional

  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1346421658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-709-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JUDITH",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC000691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103757394",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - PC",
            "identifier": "PC000691",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11836138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarity Assessments and Psychological Services, LLC
• Christy Joy Clark, BA
• Cody Clark
• David P. Clark, M.D.
• Joseph Martin Clark, M.D.
• Thomas W Clark, DPM
• Bridgette Elizabeth Clarke, PSYD
• Leela A Cleary, AUD
• Thomas M Clemens, MD
• Kaila Alexis Clift, D.M.D.

• Professional Counselor in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.