| Darcie R Clark Lpcc Llc | |
|
11 W Monument Ave Ste 100 Dayton OH 45402-1293 | |
| (937) 319-4448 | |
| Not Available |
| Full Name | Darcie R Clark Lpcc Llc |
|---|---|
| Speciality | Counselor |
| Location | 11 W Monument Ave Ste 100, Dayton, Ohio |
| Authorized Official Name and Position | Darcie Rupert Clark (OWNER) |
| Authorized Official Contact | 9376711589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Darcie R Clark Lpcc Llc 11 W Monument Ave Ste 100 Dayton OH 45402-1293 Ph: (937) 319-4448 | Darcie R Clark Lpcc Llc 11 W Monument Ave Ste 100 Dayton OH 45402-1293 Ph: (937) 319-4448 |
| NPI Number | 1669842258 |
|---|---|
| Provider Enumeration Date | 09/25/2015 |
| Last Update Date | 07/27/2022 |
| Certification Date | 07/27/2022 |
| Medicare PECOS PAC ID | 3779958947 |
|---|---|
| Medicare Enrollment ID | O20230331002603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669842258 | NPI | - | NPPES |
| 0342414 | Medicaid | OH | |
| 0320539 | Medicaid | OH |
| Provider Name | Darcie R Clark |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1003149808 PECOS PAC ID: 9830563220 Enrollment ID: I20230327001511 |
| Provider Name | Jay Wainscott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548754146 PECOS PAC ID: 5496107963 Enrollment ID: I20240119003131 |
| Provider Name | Melisa Andrews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013261437 PECOS PAC ID: 6901258409 Enrollment ID: I20240120000092 |
| Provider Name | Larry Daniel Stephens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457705600 PECOS PAC ID: 4587017819 Enrollment ID: I20240202000066 |
| Provider Name | Wesley Bass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689070260 PECOS PAC ID: 9739524778 Enrollment ID: I20240229000471 |
| Provider Name | Ashlyn Eades |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891433199 PECOS PAC ID: 4880068261 Enrollment ID: I20240516002218 |
| Provider Name | Curtis A Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417682220 PECOS PAC ID: 7911434725 Enrollment ID: I20241218000540 |
| Provider Name | Devin Sonner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386379717 PECOS PAC ID: 0143740654 Enrollment ID: I20250226003253 |
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