Gilbert Clark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

02015 Issued in MN

Practice address

520 Cobb St
Cadillac, MI 49601-2588

Phone

(231) 775-6521

Fax

(231) 775-1366

NPI assigned

Sep 10, 2015

Last updated

Aug 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baldwin Family Health CareGroup PAC ID 1153215413, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gilbert.clark.p1@direct.bfhc.nextgenshare.com
• Direct secure messaging: gilbert.clark.p1@direct.nextgenshare.com

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.

• Baldwin Family Health Care

  • Federally Qualified Health Center (FQHC)
  • Baldwin, MI
  • NPI 1689783698
  Medicare reassignment Care Compare group NPD
• Baldwin Family Health Care

  dba Family Health Care Pharmacy

  • Community/Retail Pharmacy
  • Big Rapids, MI
  • NPI 1497640213
  NPD
• Baldwin Family Health Care

  dba Great Lakes Family Care

  • Federally Qualified Health Center (FQHC)
  • Cadillac, MI
  • NPI 1982815932
  NPD

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1982072765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-876-6527",
            "fax_number": "231-876-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-775-6521",
            "fax_number": "231-775-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GILBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-10",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01085",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303944",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gilbert.clark.p1@direct.nextgenshare.com",
            "affiliation": "N",
            "address_1": "520 Cobb St",
            "city": "Cadillac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496012588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chowdhury MD PLLC
• Shoaib Ahmed Chowdhury, MD
• Julie Churchill
• Courtney L Cieslik-Shann
• Clark Counseling Services PLLC
• Megan Clark, LLMSW
• Theresa Marie Clark, BT
• Bridget Clough, PHARMD
• Cassandra Lynn Coburn, B.S.
• Jacob Cochrane, R.PH.

• Professional Counselor in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.