Anna Lisa Clark, LISW, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

862262 Issued in OH

Practice address

35888 Center Ridge Rd
Suite 5
North Ridgeville, OH 44039-3086

Phone

(440) 327-1800

Fax

(440) 327-1533

NPI assigned

Jul 12, 2006

Last updated

Sep 11, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Clinical Social Worker

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  OH

  Medicare reassignment Care Compare group NPD
• Autumn Treatment Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Washington Court House, OH
  • NPI 1225601826
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, OH

  Medicare reassignment NPD
• Autumn Treatment Center LLC

  • Family Medicine Physician
  • Springfield, OH
  • NPI 1104633221
  NPD
• Autumn Treatment Center LLC

  • Clinic/Center
  • Washington Court House, OH
  • NPI 1275112815
  NPD
• Bayshore Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Sandusky, OH
  • NPI 1821357625
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1457376485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35888 CENTER RIDGE RD",
            "address_2": "SUITE 5",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440393086",
            "telephone_number": "440-327-1800",
            "fax_number": "440-327-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35888 CENTER RIDGE RD",
            "address_2": "SUITE 5",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440393086",
            "telephone_number": "440-327-1800",
            "fax_number": "440-327-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANNA",
        "middle_name": "LISA",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "862262",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0007941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mundeep Chaudhry, MD
• Ibrahim Chkhaidze
• Kaycie Churchill
• James P Cicero, OCCUPATIONAL THERAPI
• City of North Ridgeville
• Kimberley M Clough
• Conversations for Change Counseling Services, Inc. (Conversations for Change Counseling Services)
• Kathleen Cook, BCBA
• Karen Cooney, OTR/L
• Kathleen Ann Cooper, PTA

• Addiction (Substance Use Disorder) Counselor in North Ridgeville, OH
• Providers in North Ridgeville, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.