Jessica Ilo Clark, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8125 Issued in SC

Practice address

20 Powderhorn Rd
Simpsonville, SC 29681-3399

Phone

(864) 963-3421

Fax

(864) 962-0758

NPI assigned

Aug 10, 2018

Last updated

Aug 20, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, 226 clinicians

Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

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.

• South Carolina Dept of Mental Health Accounting Office

  dba Greenville Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenville, SC
  • NPI 1619995370
  Medicare reassignment Care Compare group NPD
• Talkspace Provider Network PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1639814049

  SC

  Medicare reassignment Care Compare group NPD
• Jessica the Counselor, LLC

  • Professional Counselor
  • Moore, SC
  • NPI 1457037152
  NPD Authorized official
• South Carolina Dept of Mental Health Accounting Office

  dba Greater Greenville Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenville, SC
  • NPI 1013476787
  NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Midlands Crisis Stabilization Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Piedmont Center for Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Simpsonville, SC
  • NPI 1306949482
  NPD (past)

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1902385875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 POWDERHORN RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813399",
            "telephone_number": "864-963-3421",
            "fax_number": "864-962-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 POWDERHORN RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813399",
            "telephone_number": "864-963-3421",
            "fax_number": "864-962-0758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "591 Gas Plant Rd",
            "address_purpose": "LOCATION",
            "city": "Moore",
            "state": "SC",
            "postal_code": "293699424",
            "country_code": "US",
            "telephone_number": "602-354-1562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JESSICA",
        "middle_name": "ILO",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Helena Christie, MS, RD
• Rosalyn McFadden Clanton
• Sarah Wilson Clardy, MSW
• Clark Optometric Center of SC, P.a. (Triangle Visions Optometry)
• Ashley Lucas Clark, M.D.
• Julie Theriot Clark, RN
• Mark Anthony Clark, PT
• Nikkie Clark, LMSW
• Kristin Claude, APRN
• Tyler Clausen, DMD

• Professional Counselor in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.