AUTUMN ROSE CLARK
NPI 1528908688
Counselor - Professional in Rome, GA

Q: What is Autumn Clark's NPI number?

The NPI number for Autumn Clark is 1528908688. It was assigned to this individual provider in the NPPES registry on March 30, 2026.

Q: What is Autumn Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Autumn Clark was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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 March 30, 2026PECOS Enrolled

6095 BIG TEXAS VALLEY RD NW, ROME, GA 30165(619) 342-5933 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Autumn Rose Clark NPPES

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

AUTUMN ROSE CLARK (NPI 1528908688) is an individual professional provider in Rome, Georgia, licensed in Georgia (APC010509) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1528908688

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameAUTUMN ROSE CLARK

Location Address6095 BIG TEXAS VALLEY RD NWRome, GA 30165-9753

Mailing Address6095 Big Texas Valley Rd NwRome, GA 30165-9753 · (619) 342-5933

Phone(619) 342-5933

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateMarch 30, 2026

NPPES CertifiedMarch 30, 2026

✔ NPI 1528908688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in GA · APC010509

6095 BIG TEXAS VALLEY RD NW, Rome, GA 30165

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn Rose Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577037555

PECOS Enrollment IDI20260630004205

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.

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 Autumn Clark's NPI number?

The NPI number for Autumn Clark is 1528908688. It was assigned to this individual provider in the NPPES registry on March 30, 2026.

Where is Autumn Clark located?

Autumn Clark practices at 6095 Big Texas Valley Rd NW, Rome, GA 30165. The listed phone number is (619) 342-5933.

What is Autumn Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Autumn Clark enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Autumn Clark was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.