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DR. DYNETTA CLARK LPC-S, LPC, LMHC
NPI 1003125261
Counselor - Professional in Austin, TX

Active since October 05, 2010PECOS Enrolled
5900 BALCONES DR STE 4000, AUSTIN, TX 78731(512) 200-3926 Get Directions Write a Review

NPPES record last updated: January 21, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 21, 2026, Jan 17, 2026, Jan 11, 2026 (3 updates tracked since 2026).

About Dr. Dynetta Clark Lpc-s, Lpc, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DYNETTA CLARK LPC-S, LPC, LMHC (NPI 1003125261) is an individual professional provider in Austin, Texas, licensed in Texas (88846) and active in the NPI registry since October 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1003125261
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameDR. DYNETTA CLARKCredential: LPC-S, LPC, LMHC
Location Address5900 BALCONES DR STE 4000Austin, TX 78731-4257
Mailing Address5900 Balcones Dr Ste 4000Austin, TX 78731-4257 · (512) 200-3926
Phone(512) 200-3926
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 5, 2010
Last NPPES UpdateJanuary 21, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 21, 2026
✔ NPI 1003125261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 88846
5900 BALCONES DR STE 4000, Austin, TX 78731
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company, WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dynetta Clark Lpc-s, Lpc, Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991261844
PECOS Enrollment IDI20260730002786
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Dynetta Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bluebonnet Trails Community Mhmr Center
13 mi
Mental Health (Including Community Mental Health Center)
1009 N GEORGETOWN ST
Round Rock, TX 78664
  • Reassigned Medicare billing, Texas enrollment
  • 216 clinicians in this Medicare group
NPI 1730135864 (512) 255-1720

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TEXAS MIND AND BODY PSYCHIATRIC SERVICES PLLC
Nurse Practitioner (Psychiatric/Mental Health)
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (512) 309-5477
CHRISTOPHER CHASE MONROE
Counselor (Professional)
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (254) 366-6674
MRS. ELIZABETH KIDD WELWOOD LPC
Counselor (Professional)
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (214) 533-9857
CAITLIN MOYA LMFT
Counselor (Mental Health)
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (682) 551-6814
GILLIAN GALLO M.A., LPC-A
Counselor
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (512) 546-3038
CONNIE MARIE HERNANDEZ LCSW
Social Worker (Clinical)
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (832) 304-3805
SEEDS OF CARE PEDIATRIC THERAPY SERVICES PLLC
Speech-Language Pathologist
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (228) 918-9565
DR. KIMBERLY GARRISON, PLLC
Psychologist
5900 BALCONES DR STE 4000
AUSTIN, TX 78731
Travis County (512) 503-1234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dynetta Clark's NPI number?

The NPI number for Dynetta Clark is 1003125261. It was assigned to this individual provider in the NPPES registry on October 5, 2010.

Where is Dynetta Clark located?

Dynetta Clark practices at 5900 Balcones Dr Ste 4000, Austin, TX 78731. The listed phone number is (512) 200-3926.

What is Dynetta Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Dynetta Clark enrolled in Medicare?

Yes. Dynetta Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Dynetta Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dynetta Clark reassigns Medicare benefits to Bluebonnet Trails Community Mhmr Center (Round Rock, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dynetta Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dynetta Clark accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company and WellPoint list Dynetta Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dynetta Clark was last updated on January 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.