Individual provider Active NPI

Joni Clark

  • Professional Counselor
  • Aberdeen, SD
National Provider Identifier
1851006407
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC20806 Issued in SD
Practice address
14 S Main St Ste 1E
Aberdeen, SD 57401-4189
Phone
(605) 225-1010
Fax
(605) 725-8055
NPI assigned
Jan 18, 2023
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X LPC20806 SD Primary

Addresses

Primary practice location

14 S Main St Ste 1E
Aberdeen, SD 57401-4189

Mailing address

14 S Main St Ste 1E
Aberdeen, SD 57401-4189
Phone (605) 225-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20240131003001 SD Practitioner - Mental Health Counselor 1557714730 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Mental Health CenterGroup PAC ID 0446155816, 12 clinicians

Practice addresses (Care Compare)

14 S Main St
Suite 1E
Aberdeen, SD 57401-4189
Phone (605) 225-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Mental Health Center Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

14 S Main St
Ste 1E
Aberdeen, SD 57401
Phone (605) 225-1010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1851006407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S MAIN ST STE 1E",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014189",
            "telephone_number": "605-225-1010",
            "fax_number": "605-725-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S MAIN ST STE 1E",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014189",
            "telephone_number": "605-225-1010",
            "fax_number": "605-725-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JONI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPC20806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

Verify at the official NPI Registry.