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

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: October 25, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Katherine Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rochester General Hospital
1.0 mi
General Acute Care Hospital
1425 PORTLAND AVE
Rochester, NY 14621
  • Reassigned Medicare billing, New York enrollment
  • 2,285 clinicians in this Medicare group
NPI 1063531929 (585) 922-4000
The Unity Hospital Of Rochester
1.6 mi
General Acute Care Hospital
100 KINGS HWY S
Rochester, NY 14617
  • Reassigned Medicare billing, New York enrollment
  • 1,442 clinicians in this Medicare group
NPI 1457395766 (585) 922-1900

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.

TODD GEROME MIX LMSW
Counselor (Mental Health)
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2570
MS. ARLENE PUSTALKA R.N.
Registered Nurse
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2500
RACHAEL ELIZABETH ROSS MHC
Counselor (Mental Health)
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2500
JOSEPH PIERRE
Social Worker
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2742
ROBERT SWIERCZEK CASE MANAGER
Case Manager/Care Coordinator
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2742
KATHERINE L ALLKOFER MSW
Counselor (Mental Health)
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2500
BRITTANY MARIE BOWHALL MHC
Case Manager/Care Coordinator
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-2728
MATTHEW IORIO MSW
Social Worker (Clinical)
490 E RIDGE RD
ROCHESTER, NY 14621
Monroe County (585) 922-9900

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 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.

Where is Katherine Clark located?

Katherine Clark practices at 490 E Ridge Rd, Rochester, NY 14621. The listed phone number is (585) 922-2500.

What is Katherine Clark's specialty?

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

Is Katherine Clark enrolled in Medicare?

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

Which organizations bill Medicare for Katherine Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katherine Clark reassigns Medicare benefits to 2 organizations: Rochester General Hospital (Rochester, NY) and The Unity Hospital Of Rochester (Rochester, NY). 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 Katherine 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 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 2 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.