Maria G Clark, LPC, LISAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-13317 Issued in AZ

Practice address

3260 N Hayden Rd
Suite 112
Scottsdale, AZ 85251-6649

Phone

(480) 804-0326

Fax

(480) 804-0083

NPI assigned

Dec 13, 2006

Last updated

Oct 13, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Maria G Clark Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Raymond W Lemberg PHD PCGroup PAC ID 3375578917, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Raymond W Lemberg PHD PC

  dba Psychological Pahtways

  • Psychologist
  • Glendale, AZ
  • NPI 1710162888

  Clinical

  Medicare reassignment Care Compare group NPD
• Arizona Therapy Associates, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1033564042
  NPD (past)
• Buena Vista Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Chandler, AZ
  • NPI 1053979724
  NPD (past)
• Buena Vista Recovery, LLC

  • Physical Disabilities Residential Treatment Facility
  • Chandler, AZ
  • NPI 1912523549
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1750442596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E SOUTHERN AVE",
            "address_2": "STE. 735",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825691",
            "telephone_number": "480-804-0326",
            "fax_number": "480-302-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 N HAYDEN RD",
            "address_2": "SUITE 112",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516649",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARIA",
        "middle_name": "G",
        "credential": "LPC, LISAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LISAC-10628",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-13317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559377",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "CLARK",
            "middle_name": "G",
            "credential": "LPC, LISAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Marie Clark, DDS
• Kendall Clark
• Kendra Marie Clark, PA-C
• Kenya S Clark, LCSW
• Kristen M Clark, AUD
• Michael Allen Clark, RPH
• Ray Nelson Clark, PHARMD
• Robert Wallace Clark III, DDS
• Tracy Clark, LCSW
• Alexandra Clarke

• Professional Counselor in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.