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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

LETRICIA LENISE CLARK NURSE PRACTITIONER
NPI 1255844023
Nurse Practitioner - Psychiatric/Mental Health in Pontiac, MI

Active since November 14, 2017PECOS Enrolled
461 W HURON ST STE 103, PONTIAC, MI 48341(248) 724-7600(248) 724-6800 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 27, 2026, Nov 17, 2017 (2 updates tracked since 2017).

About Letricia Lenise Clark Nurse Practitioner NPPES

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

LETRICIA LENISE CLARK NURSE PRACTITIONER (NPI 1255844023) is an individual psychiatric/mental health provider in Pontiac, Michigan, licensed in Michigan (4704261814) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255844023
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameLETRICIA LENISE CLARKCredential: NURSE PRACTITIONER
Location Address461 W HURON ST STE 103Pontiac, MI 48341-1601
Mailing AddressPo Box 430150Pontiac, MI 48343-0150 · (248) 724-7600 · Fax (248) 724-6800
Phone(248) 724-7600
Fax(248) 724-6800
Sole ProprietorNo
Enumeration DateNovember 14, 2017
Last NPPES UpdateOctober 20, 20262 updates tracked since enumeration
NPPES CertifiedOctober 20, 2026
✔ NPI 1255844023 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
License✔ Licensed in MI · 4704261814
461 W HURON ST STE 103, Pontiac, MI 48341
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Letricia Lenise Clark Nurse Practitioner 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 Reassignment

Medicare enrollment records show Letricia Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Oakland Integrated Healthcare Network
0.1 mi
Hospitalist
461 W HURON ST, SUITE 107
Pontiac, MI 48341
  • Reassigned Medicare billing, Michigan enrollment
  • 46 clinicians in this Medicare group
NPI 1114383320 (248) 724-7600

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 48341 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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 2

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

MRS. ALEXANDRA RUPP HAGERMAN MSN, APRN, FNP-C
Nurse Practitioner (Family)
461 W HURON ST STE 103
PONTIAC, MI 48341
Oakland County (248) 724-7600
MISHELLE GARCES LOPEZ
Family Medicine
461 W HURON ST STE 103
PONTIAC, MI 48341
Oakland County (248) 724-7600

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 Letricia Clark's NPI number?

The NPI number for Letricia Clark is 1255844023. It was assigned to this individual provider in the NPPES registry on November 14, 2017.

Where is Letricia Clark located?

Letricia Clark practices at 461 W Huron St Ste 103, Pontiac, MI 48341. The listed phone number is (248) 724-7600.

What is Letricia Clark's specialty?

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

Is Letricia Clark enrolled in Medicare?

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

Which organization bills Medicare for Letricia Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Letricia Clark reassigns Medicare benefits to Oakland Integrated Healthcare Network (Pontiac, MI). The 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 Letricia Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Letricia Clark accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Letricia 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 Letricia Clark was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days 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.