MS. LESLIE A. CLARK LPC, CSAC, CIR, ICS-
NPI 1497092704
Counselor - Mental Health in Oak Creek, WI

Q: What is Leslie Clark's NPI number?

The NPI number for Leslie Clark is 1497092704. It was assigned to this individual provider in the NPPES registry on January 7, 2013.

Q: What is Leslie Clark's specialty?

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

Q: Is Leslie Clark enrolled in Medicare?

No. Leslie Clark has opted out of Medicare through October 4, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Leslie Clark was last updated on April 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.

Active since January 07, 2013Opted out of Medicare · through Oct 4, 2026

7071 S. 13TH STREET, SUITE 100, OAK CREEK, WI 53154(414) 367-6698 Get Directions Write a Review

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

Record update history: Apr 17, 2024, Mar 7, 2019 (2 updates tracked since 2019).

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About Ms. Leslie A. Clark Lpc, Csac, Cir, Ics- NPPES

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

MS. LESLIE A. CLARK LPC, CSAC, CIR, ICS- (NPI 1497092704) is an individual mental health provider in Oak Creek, Wisconsin, licensed in Wisconsin (5204-125) and active in the NPI registry since January 2013. She has opted out of Medicare through October 4, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1497092704

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMS. LESLIE A. CLARKCredential: LPC, CSAC, CIR, ICS-

Location Address7071 S. 13TH STREET, SUITE 100Oak Creek, WI 53154

Mailing Address11011 W. North Ave., Apt.309Wauwatosa, WI 53226 · (414) 367-6698

Phone(414) 367-6698

Sole ProprietorNo

Enumeration DateJanuary 7, 2013

Last NPPES UpdateApril 17, 20242 updates tracked since enumeration

NPPES CertifiedApril 17, 2024

✔ NPI 1497092704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Licenses✔ Licensed in WI · 5204-125✔ Licensed in WI · 16215-132

Also ListedSocial WorkerTaxonomy 104100000X · License 1180-226 (WI)

7071 S. 13TH STREET, Oak Creek, WI 53154

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Other Identifiers 1

Medicaid100027595WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Ms. Leslie A. Clark Lpc, Csac, Cir, Ics- 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 October 4, 2024 through October 4, 2026.

Opt-Out Effective DateOctober 4, 2024

Opt-Out In Effect ThroughOctober 4, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Leslie Clark's NPI number?

The NPI number for Leslie Clark is 1497092704. It was assigned to this individual provider in the NPPES registry on January 7, 2013.

Where is Leslie Clark located?

Leslie Clark practices at 7071 S. 13th Street Suite 100, Oak Creek, WI 53154. The listed phone number is (414) 367-6698.

What is Leslie Clark's specialty?

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

Is Leslie Clark enrolled in Medicare?

No. Leslie Clark has opted out of Medicare through October 4, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Leslie Clark accept?

Health plans from Providence Health Plan list Leslie 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 Leslie Clark was last updated on April 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.