Nicole Albano Clark, LPC

Individual provider Active NPI Professional Counselor · Marion, VA

NPI 1548029325 · NPPES record last updated Mar 15, 2024

Key facts

NPI
1548029325
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
0701013357 (VA)
Practice address
216 Hospital Ave
Marion, VA 24354-3157
Phone
(276) 783-8185
Fax
(276) 783-5030
NPI assigned
Mar 15, 2024
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Rogers Community Services (33 clinicians)

Practice addresses (Care Compare)

216 Hospital Ave
Marion, VA 24354-3157
Phone (276) 783-8185

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240516004315 VA Practitioner - Mental Health Counselor 3971944224 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0701013357VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Rogers Community Services Current
since Mar 23, 2024
Accepting new patients

Locations

216 Hospital Ave
Marion, VA 24354
Phone (276) 783-8185

770 W Ridge Rd
Wytheville, VA 24382
Phone (276) 223-3200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 0701013357 VA Yes

Addresses

Primary practice location

216 Hospital Ave
Marion, VA 24354-3157

Mailing address

770 W Ridge Rd
Wytheville, VA 24382-1187
Phone (276) 223-3200

Other names

  • Nicole Fern Albano Former name

Other providers in Marion, VA

All providers in Marion, VA · Professional Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.