Stacy Clarke, MA, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

302 W Central Ave
PO Box 50
Avis, PA 17721-8901

Phone

(570) 995-1416

NPI assigned

Dec 8, 2022

Last updated

Dec 30, 2025By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Enso Counseling & Wellness, LLC

  • Mental Health Counselor
  • Avis, PA
  • NPI 1629984489
  Authorized official Same address or phone

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1811608995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W CENTRAL AVE",
            "address_2": "PO BOX 50",
            "city": "AVIS",
            "state": "PA",
            "postal_code": "177218901",
            "telephone_number": "570-360-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W CENTRAL AVE",
            "address_2": "PO BOX 50",
            "city": "AVIS",
            "state": "PA",
            "postal_code": "177218901",
            "telephone_number": "570-995-1416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "STACY",
        "name_prefix": "Ms.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avis Behavioral Health
• Patricia Ann Dershem, LCSW
• Kelly Eichenlaub, LPC
• Enso Counseling & Wellness, LLC
• Heather Lynn Fowler, LPC
• Freeman Counseling Services

• Mental Health Counselor in Avis, PA
• Providers in Avis, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.