DR. SUSAN MARIE CLARK PH.D
NPI 1154590073
Counselor - Professional in Stockbridge, GA
About Dr. Susan Marie Clark Ph.d NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SUSAN MARIE CLARK PH.D (NPI 1154590073) is an individual professional provider in Stockbridge, Georgia, licensed in Georgia (LPC005485) and active in the NPI registry since February 2008. She has opted out of Medicare through February 11, 2027.
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Susan Marie Clark Ph.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 11, 2025 through February 11, 2027.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Susan Clark's NPI number?
The NPI number for Susan Clark is 1154590073. It was assigned to this individual provider in the NPPES registry on February 25, 2008.
Where is Susan Clark located?
Susan Clark practices at 10 Wilson Rd, Stockbridge, GA 30281. The listed phone number is (678) 438-4225.
What is Susan Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Susan Clark enrolled in Medicare?
No. Susan Clark has opted out of Medicare through February 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Susan Clark accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Susan Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Susan Clark was last updated on January 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Dr. Susan Marie Clark, PH.D · NPI 1154590073
Professional provider in Stockbridge, Georgia. Individual provider, active in the CMS NPPES registry since February 25, 2008.
## Identity
- **NPI:** 1154590073 (Entity type: Individual)
- **Enumerated:** February 25, 2008
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC005485 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10 WILSON RD, Stockbridge, GA 30281-4468
- **Phone:** (678) 438-4225 · **Fax:** (770) 506-8663
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 11, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** January 5, 2009
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Source: [NPI Profile](https://npiprofile.com/npi/1154590073) · Data from the CMS NPPES public registry.