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

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: November 01, 2026.

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

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
Open in Google Maps ↗

Other Identifiers 2

Other0005632144IL · Blue Cross Blue Shield #
Other22634IL · Cadc Certification

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

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.

Medicare Billing Reassignment

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

Centennial Counseling Center, PC
1.3 mi
Mental Health
1120 E MAIN ST, STE. 201
St Charles, IL 60174
  • Reassigned Medicare billing, Illinois enrollment
  • 29 clinicians in this Medicare group
NPI 1376544387 (630) 377-6613

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.

KATELYN LEE O'CONNELL LSW
Social Worker
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
STAVROULA HELEN CARIBACAS-RENDAS LPC
Counselor (Professional)
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
DR. TIMOTHY R. BUHRT PSY.D.
Psychologist (Clinical)
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
EILEEN C SULLIVAN LCSW
Social Worker (Clinical)
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
INGO WEIGOLD LPC
Counselor (Mental Health)
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
AUTUMN MICHELE WIBORG LPC
Counselor (Mental Health)
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
JAMES R OTEPKA LMFT
Marriage & Family Therapist
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613
DEBRA ERNST LCPC
Counselor (Professional)
1120 E MAIN ST STE 201
ST CHARLES, IL 60174
Kane County (630) 377-6613

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 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.

Where is Mary Clarke located?

Mary Clarke practices at 1120 E Main St Ste 201, St Charles, IL 60174. The listed phone number is (630) 377-6613.

What is Mary Clarke's specialty?

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

Is Mary Clarke enrolled in Medicare?

Yes. Mary Clarke 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 Mary Clarke's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Clarke reassigns Medicare benefits to Centennial Counseling Center, PC (St Charles, IL). 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 Mary Clarke's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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 6 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.