MARY CATHERINE (KAY) CLARKE MA, LCPC, CADC
NPI 1114077567
Counselor - Mental Health in St Charles, IL

Q: What is Mary Clarke's NPI number?

The NPI number for Mary Clarke is 1114077567. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Q: What is Mary Clarke'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 Mary Clarke was last updated on April 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since January 10, 2007PECOS EnrolledAccepts Medicare Assignment

1120 E MAIN ST STE 201, ST CHARLES, IL 60174(630) 377-6613(630) 377-6225 Get Directions Write a Review

NPPES record last updated: April 15, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 15, 2026, Apr 22, 2019 (2 updates tracked since 2019).

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About Mary Catherine (kay) Clarke Ma, Lcpc, Cadc NPPES

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

MARY CATHERINE (KAY) CLARKE MA, LCPC, CADC (NPI 1114077567) is an individual mental health provider in St Charles, Illinois, licensed in Illinois (180-005377) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1114077567

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMARY CATHERINE (KAY) CLARKECredential: MA, LCPC, CADC

Location Address1120 E MAIN ST STE 201St Charles, IL 60174-2287

Mailing Address1120 E Main St Ste 201St Charles, IL 60174-2287 · (630) 377-6613 · Fax (630) 377-6225

Phone(630) 377-6613

Fax(630) 377-6225

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateJanuary 10, 2007

Last NPPES UpdateApril 15, 20262 updates tracked since enumeration

NPPES CertifiedApril 15, 2026

✔ NPI 1114077567 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 IL · 180-005377

1120 E MAIN ST STE 201, St Charles, IL 60174

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Other Identifiers 2

Other0005632144IL · Blue Cross Blue Shield #

Other22634IL · Cadc Certification

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

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

Mary Catherine (kay) Clarke Ma, Lcpc, Cadc 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 ID1557713849

PECOS Enrollment IDI20240123001873

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 20

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

KATELYN LEE O'CONNELL LSW

Social Worker