Craig Steven Clark, LMHC
Individual provider Active NPI Professional Counselor · Ankeny, IA
NPI 1780165696 · NPPES record last updated Dec 17, 2025
Key facts
- NPI
- 1780165696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 124790 (IA)
- Practice address
- 2525 N. Ankeny Blvd
Suite 113
Ankeny, IA 50023-4708 - Phone
- (515) 289-9136
- Fax
- (515) 289-9139
- NPI assigned
- Aug 28, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2525 N Ankeny Blvd
Suite 113
Ankeny, IA 50023-4708
Phone (515) 289-9136
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250220001415 | IA | Practitioner - Mental Health Counselor | 7810340585 | Practice locations: Ankeny, IA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124790 | IA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 124790 | IA | |
| Professional Counselor | 101YP2500X | 1892 | MN | |
| Professional Counselor | 101YP2500X | 124790 | IA | Yes |
Addresses
Primary practice location
2525 N. Ankeny Blvd
Suite 113
Ankeny, IA 50023-4708
Mailing address
2525 N. Ankeny Blvd
Suite 113
Ankeny, IA 50023-4708
Phone (515) 289-9136
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0421348 | Medicaid | IA |
Other providers in Ankeny, IA
- Hannah Cirks
- Cynthia Pletcher Cisneros
- City of Ankeny
- Julia Madalena Civettini
- Cabrie Joylyn Claiser
- Danielle Jo Clark
- Gregory James Clark
- Joy D Clark
- Leah Jean Clark
- Sarah Elizabeth Clark
All providers in Ankeny, IA · Professional Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.