NPIMap

Organization Active NPI

Darcie R Clark LPCC LLC

  • Professional Counselor
  • Dayton, OH
National Provider Identifier
1669842258
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
DARCIE R CLARK LPCC LLC
Practice address
11 W Monument Ave Ste 100
Dayton, OH 45402-1293
Phone
(937) 319-4448
NPI assigned
Sep 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Authorized official

Name
Darcie Rupert Clark, LPCC-S, NCC, LCDCIIINPI 1003149808
Title
Owner
Phone
(937) 671-1589

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

11 W Monument Ave Ste 100
Dayton, OH 45402-1293

Mailing address

11 W Monument Ave Ste 100
Dayton, OH 45402-1293
Phone (937) 319-4448

Other practice location 1

761 Miamisburg Centerville Rd
Dayton, OH 45459-6501
Phone (937) 319-4448

Other identifiers 2

IdentifierTypeStateIssuer
0342414MedicaidOH
0320539MedicaidOH

Other names 1

  • Riverscape Counseling Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.therapynotes.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230331002603 OH Part B Supplier - Clinic/Group Practice 3779958947 Receives reassigned benefits from 13 practitioners
Practice locations: Dayton, OH; Springfield, OH; Springboro, OH
O20240212001334 IN Part B Supplier - Clinic/Group Practice 3779958947 Receives reassigned benefits from 2 practitioners
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

1455 N Pennsylvania St
Indianapolis, IN 46202
Phone (937) 319-4448

11 W Monument Ave
Ste 100
Dayton, OH 45402
Phone (937) 319-4448

11 W Monument Ave
Ste 310
Dayton, OH 45402

1730 E High St
Springfield, OH 45505
Phone (937) 322-6411

761 Miamisburg Centerville Rd
Washington Township, OH 45459
Phone (937) 319-4448

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1669842258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W MONUMENT AVE STE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021293",
            "telephone_number": "937-319-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W MONUMENT AVE STE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021293",
            "telephone_number": "937-319-4448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "761 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454596501",
            "country_code": "US",
            "telephone_number": "937-319-4448",
            "fax_number": "937-630-4391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DARCIE R CLARK LPCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DARCIE",
        "authorized_official_middle_name": "RUPERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-671-1589",
        "authorized_official_credential": "LPCC-S, NCC, LCDCIII"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0342414",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320539",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.therapynotes.com",
            "affiliation": "N",
            "endpointDescription": "clinical notes and documentation portal",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Documentation",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Electronic virtual records",
            "address_1": "11 W Monument Ave Ste 100",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454021293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Riverscape Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.