Allison Rae Clark, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.2202995 Issued in OH

Practice address

22001 Fairmount Blvd
Cleveland, OH 44118-4819

Phone

(216) 932-8624

NPI assigned

Jan 15, 2019

Last updated

Jan 30, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Psychological & Behavioral Consultants, LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1861966616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441184897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-932-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALLISON",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1902217",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2202995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Claridge, MD
• Clarity Wellness Behavioral Health Center, LLC
• Nadia Angela Clarizia, MD
• Vivian A. Clark-Jacobs, PA-C
• Alexis Breaja Clark
• Alyssa Clark, OTR/L
• Bernadette Clark, QMHS 3YRS CMS HS
• Brian K Clark Sr.
• Briana Lashae Clark, HIGH SCHOOL DIPLOMA
• Chaundrea Nicole Clark, STNA

• Mental Health Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.