Lecretia Williams Clark, M.ED, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3389 Issued in MS

Practice address

2705 Highway 51 S
Hernando, MS 38632-2634

Phone

(662) 449-1971

Fax

(662) 449-1974

NPI assigned

Apr 10, 2015

Last updated

Sep 2, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• Right Track Medical Group, Inc

  • Psychiatry Physician
  • Olive Branch, MS
  • NPI 1972080257
  Medicare reassignment NPD
• Precise Clinical Neuroscience Specialists

  dba Right Track Medical Group

  • Psychiatry Physician
  • Flowood, MS
  • NPI 1770717449
  NPD (past)
• Region IV Mental Health Services

  dba Timber Hills

  • Community/Behavioral Health Agency
  • Corinth, MS
  • NPI 1154601219
  NPD (past)
• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Corinth, MS
  • NPI 1942579826
  NPD (past)

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1821484494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N MADISON ST",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388345072",
            "telephone_number": "662-286-9883",
            "fax_number": "662-284-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HIGHWAY 51 S",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386322634",
            "telephone_number": "662-449-1971",
            "fax_number": "662-449-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LECRETIA",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "M.ED, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "3389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cormelanie Shondell Chillous, PCMHT
• Eu Gene Chin, PHD INTERN
• Sushma Chowdhary, MD
• Yashwant M Chowdhary, MD
• City of Hernando Ambulance
• William Clark0
• Paula Clay
• D'Allegra Cochran, OTD, OTR/L
• Wendy Gail Collums, RN
• Community Dental Care,PA

• Mental Health Counselor in Hernando, MS
• Providers in Hernando, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.