Vickie Diane Clark

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

10905 NE 10TH St
Midwest City, OK 73130-2209

Phone

(918) 791-1995

NPI assigned

Sep 21, 2011

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

Enrolled in OK

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alliance Mental Health, LLCGroup PAC ID 0345670733, 27 clinicians

Alliance Mental Health - Colorado LLCGroup PAC ID 6507211075, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Alliance Mental Health, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
  • NPI 1053602649

  Counselor

  Medicare reassignment Care Compare group NPD
• Alliance Mental Health - Colorado LLC

  • Mental Health Counselor
  • Miami, OK
  • NPI 1205580040
  Medicare reassignment Care Compare group
• Alliance Mental Health Community Partnership

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
  • NPI 1679145486
  Medicare reassignment NPD
• Alliance Mental Health, LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pryor, OK
  • NPI 1659961530
  NPD
• Alliance Mental Health, LLC

  • Mental Health Counselor
  • Saddle River, NJ
  • NPI 1285520726
  NPD

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1760765374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10905 NW 10TH ST.",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "74344",
            "telephone_number": "918-791-1995",
            "fax_number": "405-769-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 NE 10TH ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731302209",
            "telephone_number": "918-791-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "VICKIE",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Sapulpa
• Antoinette Yvette Clark
• Ebonye Patrice Clark
• Leah Nicole Clark
• Torayia Clark
• Whitney Clark, LPC-CANDIDATE
• Yolanda Clark
• Andrea Clayton-Watson, P.T.
• Bryan C. Clayton
• Lauren Emily Clayton

• Counselor in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.