Individual provider Active NPI

Matthew Scott Clark, MS, LPC, NCC

  • Professional Counselor
  • Washington, DC
National Provider Identifier
1366030843
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PRC15451 Issued in DC
Practice address
3029 Martin Luther King Jr Ave SE
Washington, DC 20032-2506
Phone
(202) 948-7732
NPI assigned
Jan 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PRC15451 DC Primary
Professional Counselor 101YP2500X PC011603 PA

Addresses

Primary practice location

3029 Martin Luther King Jr Ave SE
Washington, DC 20032-2506

Mailing address

800 P St NW Apt 406
Washington, DC 20001-3377
Phone (717) 379-2790

Other practice location 1

915 Rhode Island Ave NW
Washington, DC 20001-4153
Phone (202) 948-7732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20260312003712 DC Practitioner - Mental Health Counselor 0547743064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

915 Rhode Island Ave NW
Washington, DC 20001-4153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PRC15451DCMDProfessional Counselor
PC011603PAMDProfessional Counselor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1610150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1366030843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 P ST NW APT 406",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013377",
            "telephone_number": "717-379-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322506",
            "telephone_number": "202-948-7732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Rhode Island Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200014153",
            "country_code": "US",
            "telephone_number": "202-948-7732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-09",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC15451",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC011603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.