MRS. JESSICA CLARK MA
NPI 1063140465
Counselor - Mental Health in Elkhart, IN

Q: What is Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1063140465. It was assigned to this individual provider in the NPPES registry on August 12, 2022.

Q: What is Jessica Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Clark was last updated on March 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 12, 2022PECOS EnrolledAccepts Medicare Assignment

59466 COUNTY ROAD 113, ELKHART, IN 46517(574) 830-5778 Get Directions Write a Review

NPPES record last updated: March 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mrs. Jessica Clark Ma NPPES

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

MRS. JESSICA CLARK MA (NPI 1063140465) is an individual mental health provider in Elkhart, Indiana and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1063140465

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMRS. JESSICA CLARKCredential: MA

Location Address59466 COUNTY ROAD 113Elkhart, IN 46517-3644

Mailing Address59466 County Road 113Elkhart, IN 46517-3644 · (616) 617-6866

Phone(574) 830-5778

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateAugust 12, 2022

Last NPPES UpdateMarch 19, 2024

NPPES CertifiedMarch 19, 2024

✔ NPI 1063140465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

59466 COUNTY ROAD 113, Elkhart, IN 46517

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Jessica Clark Ma is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214413806

PECOS Enrollment IDI20260114000532

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.

Other Providers at the Same Location NPPES 10

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

CANDACE K SCHWARTZ LMHC

Counselor (Mental Health)