Lillie Mae Clarke

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI34780122 Issued in CA

Practice address

5603 S Central Ave
Los Angeles, CA 90011-5967

Phone

(323) 432-3700

NPI assigned

May 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Special Service for Groups, Inc.

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1891826947
  NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD (past)

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1598400848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115967",
            "telephone_number": "323-432-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115967",
            "telephone_number": "323-432-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "LILLIE",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "CI34780122",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI34780122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Edith Clarke, M.S
• Johan Alexander Clarke, MD
• Kalaki Marks Clarke, M.D.
• Kylar Dyoni Clarke
• Lenorre Ruth Clarke, M.D.
• Noreen Catherine Clarke, RN, MSN
• Orette A Clarke, D.O.
• Raiven Clarke
• Robin Michael Anthony Clarke, M.D.
• Ryan Nicholas Clarke

• Addiction (Substance Use Disorder) Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.