Darsha Darlene Clark, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC007363 Issued in GA

Practice address

154 Rainbow Way Unit 115
Fayetteville, GA 30214-3994

Phone

(678) 235-5120

Fax

(470) 264-7142

NPI assigned

Aug 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Aug 14, 2025 through Aug 14, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: darshaclark@tdh.allscriptsdirect.net

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.

• Darsha D Clark LPC LLC

  • Community/Behavioral Health Agency
  • Douglasville, GA
  • NPI 1871387001
  NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1377302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1669806840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 RAINBOW WAY UNIT 115",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143994",
            "telephone_number": "678-235-5120",
            "fax_number": "470-264-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 RAINBOW WAY UNIT 115",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143994",
            "telephone_number": "678-235-5120",
            "fax_number": "470-264-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DARSHA",
        "middle_name": "DARLENE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-24",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC007363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Christian
• Erika Danielle Ciminnisi, RBT
• Dae'Yanna Cisero, RBT
• City EMS of Georgia LLC
• Aniya Clark, RBT
• Erica Clark, LPC
• Jenise Trannell Clark, LPC
• Telisha Niketia Clark
• Torey B Clark, M.D.
• Shannon Claxton

• Mental Health Counselor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.