MS. DEIDRE' MARIE CLARK MA, LMFT
NPI 1245829548
Marriage & Family Therapist in Shakopee, MN
About Ms. Deidre' Marie Clark Ma, Lmft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. DEIDRE' MARIE CLARK MA, LMFT (NPI 1245829548) is an individual marriage & family therapist in Shakopee, Minnesota, licensed in Minnesota (3698) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Deidre' Marie Clark Ma, Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Deidre' Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Cloud, MN 56301
- Reassigned Medicare billing, Minnesota enrollment
- 4 clinicians in this Medicare group
Grand Rapids, MN 55744
- Reassigned Medicare billing, Minnesota enrollment
- 35 clinicians in this Medicare group
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 10
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 Deidre' Clark's NPI number?
The NPI number for Deidre' Clark is 1245829548. It was assigned to this individual provider in the NPPES registry on January 12, 2021.
Where is Deidre' Clark located?
Deidre' Clark practices at 200 4th Ave W Ste 300, Shakopee, MN 55379. The listed phone number is (952) 496-8445.
What is Deidre' Clark's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Deidre' Clark enrolled in Medicare?
Yes. Deidre' Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Deidre' Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Deidre' Clark reassigns Medicare benefits to 2 organizations: Behavioral Health Advocacy Services LLC (Saint Cloud, MN) and Lakeview Behavioral Health Inc. (Grand Rapids, MN). 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 Deidre' 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 Deidre' Clark was last updated on January 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Ms. Deidre' Marie Clark, MA, LMFT · NPI 1245829548
Marriage & Family Therapist provider in Shakopee, Minnesota. Individual provider, active in the CMS NPPES registry since January 12, 2021.
## Identity
- **NPI:** 1245829548 (Entity type: Individual)
- **Enumerated:** January 12, 2021
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 3698 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 4TH AVE W STE 300, Shakopee, MN 55379-1220
- **Phone:** (952) 496-8445
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Behavioral Health Advocacy Services LLC (NPI 1558929539, Saint Cloud, MN); Lakeview Behavioral Health Inc. (NPI 1154404325, Grand Rapids, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 12, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1245829548) · Data from the CMS NPPES public registry.