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KRISTINA M CLARK LPC
NPI 1083173702
Counselor - Mental Health in Charleston, WV

Active since March 13, 2019PECOS EnrolledAccepts Medicare Assignment
511 MORRIS ST, CHARLESTON, WV 25301(304) 525-7851(304) 525-1073 Get Directions Write a Review

NPPES record last updated: September 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 5, 2024, Jul 9, 2024, Mar 13, 2019 (3 updates tracked since 2019).

About Kristina M Clark Lpc NPPES

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

KRISTINA M CLARK LPC (NPI 1083173702) is an individual mental health provider in Charleston, West Virginia, licensed in West Virginia (2398) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1083173702
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKRISTINA M CLARKCredential: LPC
Location Address511 MORRIS STCharleston, WV 25301-1326
Mailing Address99 Cracker Barrel Dr Ste 100Barboursville, WV 25504-1650 · (304) 525-7851 · Fax (304) 525-1073
Phone(304) 525-7851
Fax(304) 525-1073
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateMarch 13, 2019
Last NPPES UpdateSeptember 5, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2024
✔ NPI 1083173702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WV · 2398
511 MORRIS ST, Charleston, WV 25301
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristina M Clark Lpc 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 ID2264873066
PECOS Enrollment IDI20240510001556
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 Kristina Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Prestera Center For Mental Health Services Inc
35 mi
Community/Behavioral Health
99 CRACKER BARREL DR STE 100
Barboursville, WV 25504
  • Reassigned Medicare billing, West Virginia enrollment
  • 77 clinicians in this Medicare group
NPI 1356336903 (304) 525-7851

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.

DOROTHY THOMAS LGSW
Social Worker (Clinical)
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 525-7851
JEFFREY LEE GREER LGSW
Social Worker
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 341-0511
GINA MICHELLE PUZZUOLI M.D.
Psychiatry & Neurology (Psychiatry)
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 341-0511
MRS. ROBIN SUMMERS CORNISH CPHT
Pharmacy Technician
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 341-0257
MRS. DEIDRE G DORIA LSW
Social Worker
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 341-0511
MS. ANN E JOHNSTON CRNA
Nurse Anesthetist, Certified Registered
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 388-6220
MRS. MARGARET GAIL PRATT FNP-C
Nurse Practitioner (Family)
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 341-0511
VON GROVE PRSS
Peer Specialist
511 MORRIS ST
CHARLESTON, WV 25301
Kanawha County (304) 525-7851

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 Kristina Clark's NPI number?

The NPI number for Kristina Clark is 1083173702. It was assigned to this individual provider in the NPPES registry on March 13, 2019.

Where is Kristina Clark located?

Kristina Clark practices at 511 Morris St, Charleston, WV 25301. The listed phone number is (304) 525-7851.

What is Kristina Clark's specialty?

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

Is Kristina Clark enrolled in Medicare?

Yes. Kristina Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kristina Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristina Clark reassigns Medicare benefits to Prestera Center For Mental Health Services Inc (Barboursville, WV). 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 Kristina Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kristina Clark accept?

Health plans from CareSource list Kristina 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 Kristina Clark was last updated on September 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.