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CAROLYN CLARK AC-CRNP-PMH
NPI 1124429857
Nurse Practitioner - Psychiatric/Mental Health in Carlsbad, CA

Active since September 12, 2014PECOS Enrolled
6010 HIDDEN VALLEY RD STE 115, CARLSBAD, CA 92011(760) 797-8494 Get Directions Write a Review

NPPES record last updated: August 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 14, 2026, Sep 3, 2020 (2 updates tracked since 2020).

About Carolyn Clark Ac-crnp-pmh NPPES

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

CAROLYN CLARK AC-CRNP-PMH (NPI 1124429857) is an individual psychiatric/mental health provider in Carlsbad, California, licensed in California (NP95013648) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124429857
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameCAROLYN CLARKCredential: AC-CRNP-PMH
Location Address6010 HIDDEN VALLEY RD STE 115Carlsbad, CA 92011-4219
Mailing Address3835 N Freeway Blvd Ste 100Sacramento, CA 95834-1954
Phone(760) 797-8494
Sole ProprietorNo
Enumeration DateSeptember 12, 2014
Last NPPES UpdateAugust 14, 20262 updates tracked since enumeration
NPPES CertifiedAugust 14, 2026
✔ NPI 1124429857 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in CA · NP95013648✔ Licensed in MD · AC001401
6010 HIDDEN VALLEY RD STE 115, Carlsbad, CA 92011
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carolyn Clark Ac-crnp-pmh 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 Reassignments

3

Medicare enrollment records show Carolyn Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mellow Medical Inc A Professional Corporation
91 mi
Psychiatry
8235 SANTA MONICA BLVD, SUITE 300
West Hollywood, CA 90046
  • Reassigned Medicare billing, California enrollment
  • 204 clinicians in this Medicare group
NPI 1407275886 (310) 892-4284
Mark David Levine, MD Fresno
290 mi
Psychiatry
5100 N 6TH ST, STE 135
Fresno, CA 93710
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Mark David Levine MD Professional Corporation
  • 329 clinicians in this Medicare group
NPI 1124387097 (559) 490-2067
Hefuna Mental Health Wellness LLC
2,264 mi
Psychiatry
16220 FREDERICK RD, SUITE 310
Gaithersburg, MD 20877
  • Reassigned Medicare billing, District of Columbia enrollment
  • 10 clinicians in this Medicare group
NPI 1629470547 (301) 345-1022

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

MICHAEL RYAN BUCHHOLZ
Psychiatry & Neurology (Psychiatry)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (760) 797-8494
LILIANA CECILIA SIMMONS ARNP
Nurse Practitioner (Psychiatric/Mental Health)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (855) 501-1004
STEVEN BENJAMIN ALDEN DNP, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (760) 797-8494
ROBERT ALEXANDER SEAWELL DO
Psychiatry & Neurology (Psychiatry)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (855) 501-1004
KELSEY KINGSMORE
Marriage & Family Therapist
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (855) 501-1004
ANDREA PAULITSCH-BUCKINGHAM
Psychiatry & Neurology (Psychiatry)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (760) 797-8494
MEAGHAN COTTER FNP-BC, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (855) 427-2778
LAUREN TAYLOR HOPKINS LPCC
Counselor (Professional)
6010 HIDDEN VALLEY RD STE 115
CARLSBAD, CA 92011
San Diego County (855) 501-1004

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 Carolyn Clark's NPI number?

The NPI number for Carolyn Clark is 1124429857. It was assigned to this individual provider in the NPPES registry on September 12, 2014.

Where is Carolyn Clark located?

Carolyn Clark practices at 6010 Hidden Valley Rd Ste 115, Carlsbad, CA 92011. The listed phone number is (760) 797-8494.

What is Carolyn Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Carolyn Clark enrolled in Medicare?

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

Which organizations bill Medicare for Carolyn Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Clark reassigns Medicare benefits to 3 organizations: Mellow Medical Inc A Professional Corporation (West Hollywood, CA), Mark David Levine, MD Fresno (Fresno, CA) and Hefuna Mental Health Wellness LLC (Gaithersburg, MD). Each 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 Carolyn Clark'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 Carolyn Clark was last updated on August 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.