Natasha L Clark, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.010332 Issued in IL

Practice address

600 E Diehl Rd
Naperville, IL 60563

Phone

(630) 428-7890

NPI assigned

Jan 15, 2013

Sex

Female

Sole proprietor

No

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

Enrolled in IL, WI2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: natasha.clark.2@25899.direct.athenahealth.com

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.

• Rockford Psychiatric Medical Services, S.C.

  • Psychiatry Physician
  • Rockford, IL
  • NPI 1821391442

  WI

  Medicare reassignment Care Compare group NPD
• Tricity Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Geneva, IL
  • NPI 1598850778

  Professional

  Medicare reassignment NPD
• Tricity Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Charles, IL
  • NPI 1255873519
  NPD
• Suicide Prevention Services

  • Community/Behavioral Health Agency
  • Batavia, IL
  • NPI 1518277953
  NPD (past)

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1730426370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 S BATAVIA AVE",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605102921",
            "telephone_number": "630-482-9699",
            "fax_number": "630-482-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E DIEHL RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60563",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "528 S Batavia Ave",
            "address_purpose": "LOCATION",
            "city": "Batavia",
            "state": "IL",
            "postal_code": "605102921",
            "country_code": "US",
            "telephone_number": "630-482-9699 x233",
            "fax_number": "630-482-9669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NATASHA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Jean Ciucci, LCSW
• Staci Marie Clabough, NP
• Clarity Behavioral Consulting
• Emilie Rebecca Clark
• Licieara Clark
• Sarah Clark
• Sarah B Clark, MD
• Stanley Everett Clark, MD
• Jillian Clarke, ED.D.
• Leena Ann Clarke, RBT

• Professional Counselor in Naperville, IL
• Providers in Naperville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.