KATHERINE PATRICIA CLARK LMHC
NPI 1154089639
Counselor - Mental Health in Rochester, NY

Q: What is Katherine Clark's NPI number?

The NPI number for Katherine Clark is 1154089639. It was assigned to this individual provider in the NPPES registry on December 2, 2021.

Q: What is Katherine Clark'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 Katherine Clark was last updated on October 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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 December 02, 2021PECOS Enrolled

490 E RIDGE RD, ROCHESTER, NY 14621(585) 922-2500(585) 922-2646 Get Directions Write a Review

NPPES record last updated: October 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Katherine Patricia Clark Lmhc NPPES

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

KATHERINE PATRICIA CLARK LMHC (NPI 1154089639) is an individual mental health provider in Rochester, New York and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1154089639

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKATHERINE PATRICIA CLARKCredential: LMHC

Location Address490 E RIDGE RDRochester, NY 14621-1297

Mailing Address490 E Ridge RdRochester, NY 14621-1297 · (585) 922-2500 · Fax (585) 922-2646

Phone(585) 922-2500

Fax(585) 922-2646

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 2, 2021

Last NPPES UpdateOctober 17, 2024

NPPES CertifiedOctober 16, 2024

✔ NPI 1154089639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

490 E RIDGE RD, Rochester, NY 14621

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katherine Patricia Clark Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5092210898

PECOS Enrollment IDI20250923003912

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.

TODD GEROME MIX LMSW

Counselor (Mental Health)