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KORINNE L CLARK MS,LPCC
NPI 1083967582
Counselor - Professional in Moraine, OH

Active since October 22, 2012PECOS Enrolled
3095 KETTERING BLVD, MORAINE, OH 45439(937) 293-8300 Get Directions Write a Review

NPPES record last updated: August 1, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 1, 2022, Jul 29, 2022 (2 updates tracked since 2022).

About Korinne L Clark Ms,lpcc NPPES

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

KORINNE L CLARK MS,LPCC (NPI 1083967582) is an individual professional provider in Moraine, Ohio, licensed in Ohio (E.2203025) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083967582
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKORINNE L CLARKCredential: MS,LPCC
Location Address3095 KETTERING BLVDMoraine, OH 45439-1983
Mailing Address3095 Kettering BlvdMoraine, OH 45439-1983 · (937) 293-8300
Phone(937) 293-8300
Sole ProprietorNo
Enumeration DateOctober 22, 2012
Last NPPES UpdateAugust 1, 20222 updates tracked since enumeration
NPPES CertifiedAugust 1, 2022
✔ NPI 1083967582 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 OH · E.2203025
3095 KETTERING BLVD, Moraine, OH 45439
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Korinne L Clark Ms,lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Korinne Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South Community Inc
Same address
Mental Health (Including Community Mental Health Center)
3095 KETTERING BLVD
Moraine, OH 45439
  • Reassigned Medicare billing, Ohio enrollment
  • 50 clinicians in this Medicare group
NPI 1639128176 (937) 293-8300

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.

ELISSA NICHOLE HOSTETTER
Social Worker
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 534-1384
HOLLY MICHELLE VADNAIS
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
ELIZABETH LIAPIS LISW-SUPV
Social Worker (Clinical)
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
KIMBERLY YATES
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
LOGAN BRUNO
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300
MISS WILLIETTE ANDERSON
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 991-4817
HANNAH MILLER
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 534-1554
MORGAN RENCH
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Montgomery County (937) 293-8300

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 Korinne Clark's NPI number?

The NPI number for Korinne Clark is 1083967582. It was assigned to this individual provider in the NPPES registry on October 22, 2012.

Where is Korinne Clark located?

Korinne Clark practices at 3095 Kettering Blvd, Moraine, OH 45439. The listed phone number is (937) 293-8300.

What is Korinne Clark's specialty?

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

Is Korinne Clark enrolled in Medicare?

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

Which organization bills Medicare for Korinne Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Korinne Clark reassigns Medicare benefits to South Community Inc (Moraine, OH). 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 Korinne Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Korinne Clark accept?

Health plans from Molina Healthcare list Korinne 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 Korinne Clark was last updated on August 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.