Rebecca Elizabeth Clark, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

01481 Issued in MN

Practice address

1751 Southcross Dr W
Burnsville, MN 55306

Phone

(952) 892-7690

Fax

(952) 898-4930

NPI assigned

Jun 2, 2018

Last updated

Jun 2, 2018By 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 MN

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Patricia Verby Psychological Services IncGroup PAC ID 2163525031, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Patricia Verby Psychological Services Inc

  • Psychologist
  • Burnsville, MN
  • NPI 1245312818
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527897600000",
    "number": "1942792296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12814 ECHO LN",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 SOUTHCROSS DR W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55306",
            "telephone_number": "952-892-7690",
            "fax_number": "952-898-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECCA",
        "middle_name": "ELIZABETH",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-02",
        "last_updated": "2018-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy a. Alland (Dr. Cindy Alland@Sears Optical)
• Circle Sage Healing Inc.
• Daniel P Clare, OD
• Claris Eye Care & Surgery, P.a. (Claris Eye Care & Surgery)
• James C Clark, M.D.
• Carol Jean Clarke, OA, LPN
• Roger A Clausnitzer, MD
• Lauryn Marie Clay
• Kaylise D Claypool
• Clear Lakes Dental

• Mental Health Counselor in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2018; 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.